Provider Demographics
NPI:1548314800
Name:HALL, KRISTI L PICKENS (MA, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:KRISTI
Middle Name:L PICKENS
Last Name:HALL
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Gender:F
Credentials:MA, CCC-SLP
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Mailing Address - Street 1:1313 CAROLINA ST STE 100
Mailing Address - Street 2:LING & KERR PEDIATRIC THERAPY
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-6001
Mailing Address - Country:US
Mailing Address - Phone:336-370-4070
Mailing Address - Fax:336-370-9008
Practice Address - Street 1:1313 CAROLINA ST STE 100
Practice Address - Street 2:LING & KERR PEDIATRIC THERAPY
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6001
Practice Address - Country:US
Practice Address - Phone:336-370-4070
Practice Address - Fax:336-370-9008
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NC3658235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC67468KOtherBCBS
NCA4935OtherMEDCOST
NC7411051Medicaid