Provider Demographics
NPI:1992950109
Name:GIGLIOTTI, KRISTEN DEANN (MS/SLP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:DEANN
Last Name:GIGLIOTTI
Suffix:
Gender:F
Credentials:MS/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 MORNING GLORY TURN
Mailing Address - Street 2:
Mailing Address - City:RUCKERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22968-2543
Mailing Address - Country:US
Mailing Address - Phone:304-613-6430
Mailing Address - Fax:866-774-8974
Practice Address - Street 1:1159 MORNING GLORY TURN
Practice Address - Street 2:
Practice Address - City:RUCKERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22968-2543
Practice Address - Country:US
Practice Address - Phone:304-613-6430
Practice Address - Fax:866-774-8974
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV235Z00000X
VA2202006746235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist