Provider Demographics
NPI:1992869341
Name:HARM, KRISTI (SLP)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:HARM
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 INWOOD RD
Mailing Address - Street 2:
Mailing Address - City:AZLE
Mailing Address - State:TX
Mailing Address - Zip Code:76020-4818
Mailing Address - Country:US
Mailing Address - Phone:817-729-9506
Mailing Address - Fax:817-444-0938
Practice Address - Street 1:605 INWOOD RD
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-4818
Practice Address - Country:US
Practice Address - Phone:817-729-9506
Practice Address - Fax:817-444-0938
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX528501OtherBCBS