Provider Demographics
NPI:1982402624
Name:HICKMAN, KRISTY J (SLPA)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:J
Last Name:HICKMAN
Suffix:
Gender:
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5924 W 14TH CT
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-1402
Mailing Address - Country:US
Mailing Address - Phone:509-551-3181
Mailing Address - Fax:
Practice Address - Street 1:1315 N 7TH AVE
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-4174
Practice Address - Country:US
Practice Address - Phone:509-416-7848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASP615832362355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Single Specialty