Provider Demographics
NPI:1245353861
Name:BOSSE, KRISTY LYN (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:LYN
Last Name:BOSSE
Suffix:
Gender:
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 1:940 REEVES RD
Mailing Address - Street 2:
Mailing Address - City:DRY RIDGE
Mailing Address - State:KY
Mailing Address - Zip Code:41035-8335
Mailing Address - Country:US
Mailing Address - Phone:859-393-4742
Mailing Address - Fax:
Practice Address - Street 1:940 REEVES RD
Practice Address - Street 2:
Practice Address - City:DRY RIDGE
Practice Address - State:KY
Practice Address - Zip Code:41035-8335
Practice Address - Country:US
Practice Address - Phone:859-824-0309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY138937235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist