Provider Demographics
NPI:1518186055
Name:KREIGER, KATHLEEN ELLEN (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ELLEN
Last Name:KREIGER
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LITTLE FLORIDA RD
Mailing Address - Street 2:
Mailing Address - City:POQUOSON
Mailing Address - State:VA
Mailing Address - Zip Code:23662-2025
Mailing Address - Country:US
Mailing Address - Phone:757-814-0539
Mailing Address - Fax:
Practice Address - Street 1:90 SAWYER CIR
Practice Address - Street 2:#436
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103-5949
Practice Address - Country:US
Practice Address - Phone:901-248-1676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003580235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist