Provider Demographics
NPI:1972937910
Name:WHALEN, KRISTEN ELIZABETH (MA, CFY-SLP)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:WHALEN
Suffix:
Gender:F
Credentials:MA, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 KNOWLES RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-6610
Mailing Address - Country:US
Mailing Address - Phone:772-485-8428
Mailing Address - Fax:
Practice Address - Street 1:5065 WALLIS RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-1947
Practice Address - Country:US
Practice Address - Phone:561-689-1799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist