Provider Demographics
NPI:1033717939
Name:PEEMOELLER, KAY CHRISTEL
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:CHRISTEL
Last Name:PEEMOELLER
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 1:2213 ROUND HILL DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-8855
Mailing Address - Country:US
Mailing Address - Phone:757-648-2520
Mailing Address - Fax:757-471-5817
Practice Address - Street 1:2213 ROUND HILL DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-8855
Practice Address - Country:US
Practice Address - Phone:757-648-2520
Practice Address - Fax:757-471-5817
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist