Individual
MS. KRISTINA ANNA FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S CCC-SLP
Contact information
Practice address
68-3668 ELEELE ST, WAIKOLOA, HI 96738-9673
(808) 651-5766
Mailing address
PO BOX 385564, WAIKOLOA, HI 96738-0564
(808) 651-5766
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
021163
NY
235Z00000X
Speech-Language Pathologist
31596
CA
235Z00000X
Speech-Language Pathologist
Primary
SP-1274
HI
Other
Enumeration date
08/16/2011
Last updated
12/07/2021
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