Individual
KRISTA KLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.SLP
Contact information
Practice address
5325 MAIN ST, ANDERSON, IN 46013-1702
(765) 642-0201
Mailing address
5325 MAIN ST, ANDERSON, IN 46013-1702
(765) 642-0201
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22007474A
IN
235Z00000X
Speech-Language Pathologist
2202006398
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194411
ANTHEM
VA
01
—
45084
OPTIMA
VA
05
—
49-7850-1
—
VA
Enumeration date
08/12/2011
Last updated
05/20/2020
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