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General NPI Number Information
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NPI Number | 1437280823
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Entity Type | Individual
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Provider Name | MRS. KRISTEN LEIGH MOUTSOS
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 12TH ST
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City | FRANKLIN
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State | PA
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Zip | 16323-1217
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Country | US
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Telephone | 814-437-3071
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Fax | 814-432-2269
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Provider Business Mailing Address
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Address Line | 7710 SCHRECK RD
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City | MEADVILLE
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State | PA
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Zip | 16335-5228
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Country | US
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Telephone | 814-425-2859
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SL008690
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License Number State | PA
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