Provider Demographics
NPI:1528514452
Name:KRISTY KAZIAN, SLP
Entity type:Organization
Organization Name:KRISTY KAZIAN, SLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTY
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:KAZIAN
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:847-624-4341
Mailing Address - Street 1:40 MOUNTAIN SHADOWS DR
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-4608
Mailing Address - Country:US
Mailing Address - Phone:847-624-4341
Mailing Address - Fax:847-680-1295
Practice Address - Street 1:40 MOUNTAIN SHADOWS DR
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-4608
Practice Address - Country:US
Practice Address - Phone:847-624-4341
Practice Address - Fax:847-680-1295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA90172355S0801X
AZSLP7697235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty