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Individual

KRISTEN SHORES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1 BAKER PL, KEYSER, WV 26726-2824
(304) 267-3595
(304) 267-3599
Mailing address
MINERAL COUNTY BOARD OF EDUCATION, ONE BAKER PLACE, KEYSER, WV 26726
(304) 267-3595
(304) 267-3599

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1810
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1810
WV BOARD OF EXAMINERS CARD
WV
Enumeration date
09/21/2017
Last updated
07/21/2022
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