Provider Demographics
NPI:1063867901
Name:ENGEMANN, KRISTY LYNN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:LYNN
Last Name:ENGEMANN
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:GMC PEDS REHAB DEPARTMENT (27-03)
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-9800
Mailing Address - Country:US
Mailing Address - Phone:570-271-5314
Mailing Address - Fax:570-271-7963
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:GMC PEDS REHAB DEPARTMENT (27-03)
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-9800
Practice Address - Country:US
Practice Address - Phone:570-271-5314
Practice Address - Fax:570-271-7963
Is Sole Proprietor?:No
Enumeration Date:2016-04-28
Last Update Date:2016-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASL007820235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist