Provider Demographics
NPI:1508456864
Name:KREHBIEL, KERIANNA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KERIANNA
Middle Name:
Last Name:KREHBIEL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:KERIANNA
Other - Middle Name:
Other - Last Name:FREDERICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8424 COTONEASTER DR APT 3B
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7357
Mailing Address - Country:US
Mailing Address - Phone:302-233-8425
Mailing Address - Fax:
Practice Address - Street 1:511 JERMOR LN STE 102
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6152
Practice Address - Country:US
Practice Address - Phone:410-618-1090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09283235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist