Provider Demographics
NPI:1942021662
Name:SPARBEL, KRISTIN NICOLE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:NICOLE
Last Name:SPARBEL
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 1:2211 N LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-2530
Mailing Address - Country:US
Mailing Address - Phone:563-424-0439
Mailing Address - Fax:
Practice Address - Street 1:4680 11TH ST
Practice Address - Street 2:
Practice Address - City:EAST MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61244-4428
Practice Address - Country:US
Practice Address - Phone:309-792-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146015067235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist