Provider Demographics
NPI:1548447907
Name:CAMPBELL, KRISTINE LYN (MA CCC SLP)
Entity type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:LYN
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:919 WESTERN RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2138
Mailing Address - Country:US
Mailing Address - Phone:412-400-6007
Mailing Address - Fax:
Practice Address - Street 1:919 WESTERN RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2138
Practice Address - Country:US
Practice Address - Phone:412-400-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007-203235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist