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NPI Code Detail

MEDICARE: KRISTEN GHOLSON

MEDICARE: KRISTEN GHOLSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistMO

General Provider Information

NPI Number : 1306390539
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN GHOLSON
Provider Business Mailing Address
First Line : 20189 ROUTE F
Second Line :
City : HOLLIDAY
State : MO
Zip : 65258-2212
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 SOUTH ST
Second Line :
City : PARIS
State : MO
Zip : 65275-1165
Country : US
Telephone Number : 660-327-4125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2016
Last Update Date : 08/04/2016

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Directions to “ KRISTEN GHOLSON ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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