Provider Demographics
NPI:1386945764
Name:SCHITTER, KRISTIN JOLENE KNIES (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:JOLENE KNIES
Last Name:SCHITTER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:JOLENE
Other - Last Name:KNIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:295 E 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:IN
Mailing Address - Zip Code:47546-8149
Mailing Address - Country:US
Mailing Address - Phone:812-630-2833
Mailing Address - Fax:210-344-5535
Practice Address - Street 1:671 3RD AVE
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3652
Practice Address - Country:US
Practice Address - Phone:812-630-2833
Practice Address - Fax:812-301-1329
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006266A235Z00000X
TX105883235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN22006266AOtherSPEECH LANG PATH & AUDIO BOARD