Provider Demographics
NPI:1194997692
Name:KURTH, KRISTIANA S (BA IN SLP,CEIS,ICI)
Entity type:Individual
Prefix:
First Name:KRISTIANA
Middle Name:S
Last Name:KURTH
Suffix:
Gender:F
Credentials:BA IN SLP,CEIS,ICI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SONORA DR
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824
Mailing Address - Country:US
Mailing Address - Phone:978-835-9400
Mailing Address - Fax:
Practice Address - Street 1:3 SONORA DR
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-4612
Practice Address - Country:US
Practice Address - Phone:978-835-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist