Provider Demographics
NPI:1154690808
Name:KRISHNAN, KRIPA
Entity type:Individual
Prefix:
First Name:KRIPA
Middle Name:
Last Name:KRISHNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRIPA
Other - Middle Name:
Other - Last Name:CHANDRAKANTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5431 DAVIDS BEND DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5703
Mailing Address - Country:US
Mailing Address - Phone:858-449-0320
Mailing Address - Fax:
Practice Address - Street 1:3911 AVENUE I
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-3901
Practice Address - Country:US
Practice Address - Phone:858-449-0320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020701-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist