Provider Demographics
NPI:1871004796
Name:GERLING, KRISTY SUE (MS-CCC, SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTY
Middle Name:SUE
Last Name:GERLING
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 1:932 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-3057
Mailing Address - Country:US
Mailing Address - Phone:309-973-2020
Mailing Address - Fax:
Practice Address - Street 1:932 HARRISON ST
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-3057
Practice Address - Country:US
Practice Address - Phone:309-973-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01098492235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist