Provider Demographics
NPI:1487990693
Name:HEALY, KRISTA
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:HEALY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 STATION LANDING
Mailing Address - Street 2:APT 223
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02155
Mailing Address - Country:US
Mailing Address - Phone:631-804-1983
Mailing Address - Fax:
Practice Address - Street 1:1822 BEACON ST
Practice Address - Street 2:APT 4
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-2063
Practice Address - Country:US
Practice Address - Phone:631-804-1983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-14
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist