Provider Demographics
NPI:1073850236
Name:ALLEN, KRISTI L (SPCH PATH)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:ALLEN
Suffix:
Gender:F
Credentials:SPCH PATH
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:L
Other - Last Name:HELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 CEDAR ST SE
Mailing Address - Street 2:SUITE 4660
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4917
Mailing Address - Country:US
Mailing Address - Phone:505-563-6530
Mailing Address - Fax:505-563-6551
Practice Address - Street 1:201 CEDAR ST SE
Practice Address - Street 2:SUITE 4660
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4917
Practice Address - Country:US
Practice Address - Phone:505-563-6530
Practice Address - Fax:505-563-6551
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1429A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist