Provider Demographics
NPI:1689112070
Name:SONSTROM MALOWSKI, KRISTINE ELIZABETH (AUD, PHD)
Entity type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:ELIZABETH
Last Name:SONSTROM MALOWSKI
Suffix:
Gender:F
Credentials:AUD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BARBERS RD
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-9468
Mailing Address - Country:US
Mailing Address - Phone:860-402-4396
Mailing Address - Fax:330-972-7884
Practice Address - Street 1:PO BOX 900
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06349-5900
Practice Address - Country:US
Practice Address - Phone:860-694-2550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT17.000726231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist