Provider Demographics
NPI:1144517970
Name:SANKOVICH, KRISTIN (MS-CCC/SLP)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:SANKOVICH
Suffix:
Gender:F
Credentials:MS-CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 E 20TH ST
Mailing Address - Street 2:APT 202
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78722-2400
Mailing Address - Country:US
Mailing Address - Phone:512-680-7786
Mailing Address - Fax:
Practice Address - Street 1:3636 EXECUTIVE CENTER DR
Practice Address - Street 2:STE 268
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1643
Practice Address - Country:US
Practice Address - Phone:512-480-9573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107966235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist