Provider Demographics
NPI:1144522293
Name:HAUSLER, KRISTEN MARIE (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:MARIE
Last Name:HAUSLER
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 1:1407 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:CASTLETON
Mailing Address - State:NY
Mailing Address - Zip Code:12033-9574
Mailing Address - Country:US
Mailing Address - Phone:518-729-3331
Mailing Address - Fax:
Practice Address - Street 1:1407 SUNSET RD
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:NY
Practice Address - Zip Code:12033-9574
Practice Address - Country:US
Practice Address - Phone:518-729-3331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016237235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY016237OtherSPEECH LANGUAGE PATHOLOGY
12057649OtherASHA