Provider Demographics
NPI:1356740286
Name:SCHMITZ, KRISTEN (MS)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:SCHMITZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86409-0932
Mailing Address - Country:US
Mailing Address - Phone:928-897-8785
Mailing Address - Fax:
Practice Address - Street 1:1805 W HEAVENLY CT
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-2836
Practice Address - Country:US
Practice Address - Phone:928-897-8785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-15
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant