Individual provider · Type 1 NPI

Kristan M. Bullock, M.S., CCC-SLP

Speech-Language Pathologist · Idaho Falls, ID

NPI number 1689082521 Active

Practice location

3715 Woodking Dr
Idaho Falls, ID 83404-4720

Call (208) 529-2255 Map

Mailing address

2094 Autumn Ln
Idaho Falls, ID 83404-8287

Specialties and licenses

TaxonomyCodeLicense
Speech-Language Pathologist Primary 235Z00000XSLP 2623 (ID)

Speech-Language Pathologist: The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonan…

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About NPI 1689082521

Kristan M. Bullock, M.S., CCC-SLP's National Provider Identifier is 1689082521, issued on Jul 23, 2014. The primary taxonomy on file is Speech-Language Pathologist (235Z00000X), and the practice location is in Idaho Falls, ID. The record was last updated on Sep 15, 2014.