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General NPI Number Information
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NPI Number | 1841702677
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Entity Type | Organization
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Legal Business Name | KRISTINA LONDON
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 1004 MILL RUN CT
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-5245
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Country | US
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Telephone | 270-719-1467
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Fax |
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Provider Business Mailing Address
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Address Line | 1004 MILL RUN CT
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-5245
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Country | US
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Telephone | 270-719-1467
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Fax |
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Authorized Official
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Title or Position | SLP
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Name | MS. KRISTINA M LONDON
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Credential |
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Telephone | 270-719-1467
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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 | 3366
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License Number State | KY
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