Provider Demographics
NPI:1609099324
Name:SPOTTI, KRISTIE LYNN (MS-CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIE
Middle Name:LYNN
Last Name:SPOTTI
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 1:11846 PALOMINO CT
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-6712
Mailing Address - Country:US
Mailing Address - Phone:412-260-8360
Mailing Address - Fax:
Practice Address - Street 1:11846 PALOMINO CT
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-6712
Practice Address - Country:US
Practice Address - Phone:412-260-8360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008407235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101549104Medicaid