Provider Demographics
NPI:1447529953
Name:STAATS, KRISTEN ASHLEY (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:ASHLEY
Last Name:STAATS
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 1:10300 STRATHMORE HALL ST
Mailing Address - Street 2:APT 314
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3399
Mailing Address - Country:US
Mailing Address - Phone:412-715-1350
Mailing Address - Fax:
Practice Address - Street 1:5215 W CEDAR LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1548
Practice Address - Country:US
Practice Address - Phone:301-897-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06797235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist