Individual
KRISTY COUSINEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLPA
Contact information
Practice address
1204 NE 201ST AVE, FAIRVIEW, OR 97024-2499
(503) 661-7200
Mailing address
452 NE LAURA AVE, GRESHAM, OR 97030-6141
(503) 984-4017
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
09/20/2024
Last updated
09/20/2024
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