Individual
KRISTIN KING IDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
25 W INDEPENDENCE WAY, SUITE I, KINGSTON, RI 02881-1124
(401) 874-9387
(401) 874-4404
Mailing address
25 W INDEPENDENCE WAY, SUITE I, KINGSTON, RI 02881-1124
(401) 874-9387
(401) 874-4404
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00614
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2626-0
BLUE CROSS PROVIDER ID
RI
01
—
4600118
UNITED HEALTH PROVIDER ID
RI
Enumeration date
01/24/2007
Last updated
07/08/2007
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