Provider Demographics
NPI:1417298555
Name:BARTH, KRISTINA LEANNE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LEANNE
Last Name:BARTH
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:LEANNE
Other - Last Name:KINNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:510 S BIRMINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-4200
Mailing Address - Country:US
Mailing Address - Phone:972-429-3000
Mailing Address - Fax:
Practice Address - Street 1:510 S BIRMINGHAM ST
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-4200
Practice Address - Country:US
Practice Address - Phone:972-429-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106398235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist