Individual
KRISTINA LYNNE IKEMORI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
119 COBBS CV, SALTILLO, MS 38866-8751
(662) 869-0027
Mailing address
119 COBBS CV, SALTILLO, MS 38866-8751
(662) 869-0027
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S4182
MS
Other
Enumeration date
09/06/2017
Last updated
07/21/2022
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