NPI age
11 years
Enumerated 2014-07-23
● Active
Type 1 · Individual
Kristan M Bullock, M.S., CCC-SLP
Bullock is 1 of 77 speech-language pathologist providers in Idaho Falls and 1 of 1046 in Idaho.
Primary specialty
Speech-Language Pathologist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2014-09-15
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 1046 active speech-language pathologist providers in Idaho.
NPI age
11 years
≈ at median (10 yr)
State licenses
1 state
5% of peers hold multiple states
Subspecialties
0
9% of peers hold subspecialties
NPI lifetime · 2014 → 2026
2014-07Enumerated in NPPES
2014
2026
Where they practice
Practice location
3715 Woodking Dr
Idaho Falls, ID 834044720
Mailing address
2094 Autumn Ln
Idaho Falls, ID 834048287
Specialties
-
Speech-Language Pathologist PrimaryThe 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...
Practice context
Part of a multi-provider practice. 20 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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