Provider Demographics
NPI:1285991729
Name:DEGAN, KRISTIN MARIE (TSHH)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MARIE
Last Name:DEGAN
Suffix:
Gender:F
Credentials:TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ANNA MAY LN
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-4222
Mailing Address - Country:US
Mailing Address - Phone:518-456-0660
Mailing Address - Fax:
Practice Address - Street 1:2 KROSS KEYS DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1466
Practice Address - Country:US
Practice Address - Phone:518-438-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant