Provider Demographics
NPI:1689284069
Name:FERNANDEZ, KRISTEN SKONBERG (MCD, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:SKONBERG
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:ALEXA
Other - Last Name:SKONBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2008 ATHANIA PKWY
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-1912
Mailing Address - Country:US
Mailing Address - Phone:504-222-2447
Mailing Address - Fax:
Practice Address - Street 1:3740 NASHVILLE AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4344
Practice Address - Country:US
Practice Address - Phone:504-222-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202009628235Z00000X
LA7936235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist