Provider Demographics
NPI:1962580365
Name:HILL, KRISTAL MARIE (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KRISTAL
Middle Name:MARIE
Last Name:HILL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:KRISTAL
Other - Middle Name:MARIE
Other - Last Name:FORST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:170 AZALEA DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-4965
Mailing Address - Country:US
Mailing Address - Phone:479-996-5202
Mailing Address - Fax:479-996-2110
Practice Address - Street 1:170 AZALEA DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:AR
Practice Address - Zip Code:72936-4965
Practice Address - Country:US
Practice Address - Phone:479-996-5202
Practice Address - Fax:479-996-2110
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#1796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist