IndividualActive
Kristin Immicke, MS, CCC-SLP
NPI 1730698150 · Speech-Language Pathologist · West, TX
Provider details
- NPI number
- 1730698150
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- MS, CCC-SLP
- Sex
- Female
- Sole proprietor
- Yes
- License
- 111679 (TX)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Practice location
1414 Jane Ln
West, TX 76691-1012
Phone: (254) 224-7609
Fax: (254) 224-7609
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 620
West, TX 76691-0620
Registry dates
- Enumerated
- 2017-09-28
- Last updated
- 2017-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.