Provider Demographics
NPI:1992815567
Name:PRICE, KRISTINE CAPELL (MED, CCC/SLP)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:CAPELL
Last Name:PRICE
Suffix:
Gender:F
Credentials:MED, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 6TH AVE SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3907
Mailing Address - Country:US
Mailing Address - Phone:256-309-0454
Mailing Address - Fax:256-309-0422
Practice Address - Street 1:922 6TH AVE SE
Practice Address - Street 2:SUITE A
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3907
Practice Address - Country:US
Practice Address - Phone:256-309-0454
Practice Address - Fax:256-309-0422
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1449235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL04057OtherCHILDRENS REHAB. SERVICES
AL51509573PRIOtherBLUECROSS/BLUE SHIELD