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Organization
KIND PEDIATRIC THERAPY
Active
Organization
KIND PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTA WAGGONER M.A. CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(734) 620-4533
Entity
Organization
Contact information
Practice address
112 BRAVES WAY, LAVON, TX 75166-4700
(734) 620-4533
Mailing address
112 BRAVES WAY, LAVON, TX 75166-4700
(734) 620-4533
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/30/2022
Last updated
01/30/2022
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