Individual
KRISTINA LAUREN KISHIMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2482
Mailing address
2012 KEW CT, GROVETOWN, GA 30813-5891
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008932
GA
Other
Enumeration date
07/05/2016
Last updated
03/25/2024
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