Provider Demographics
NPI:1245501311
Name:DOYLE, KRISTEN ELIZABETH (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:ELIZABETH
Last Name:DOYLE
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 1:752 24TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-3312
Mailing Address - Country:US
Mailing Address - Phone:813-435-0719
Mailing Address - Fax:
Practice Address - Street 1:752 24TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-3312
Practice Address - Country:US
Practice Address - Phone:813-435-0719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-22
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 11209235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist