Individual
KRISTINA STACEY COST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
72 SALMON BROOK DR, GLASTONBURY, CT 06033-2131
(860) 633-5244
Mailing address
72 SALMON BROOK DR, GLASTONBURY, CT 06033-2131
(860) 633-5244
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
004192
CT
Other
Enumeration date
08/12/2008
Last updated
09/16/2014
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