Provider Demographics
NPI:1972080695
Name:DORSETT, KRISTEN (MS, CFY-SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:
Last Name:DORSETT
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 S SHERWOOD DR APT 2
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7044
Mailing Address - Country:US
Mailing Address - Phone:503-753-1147
Mailing Address - Fax:
Practice Address - Street 1:22461 INTERSTATE 30 S STE 301
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-2382
Practice Address - Country:US
Practice Address - Phone:501-847-2555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-25
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist