Provider Demographics
NPI:1558693572
Name:CREGG, VERONICA LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:LEE
Last Name:CREGG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:VERONICA
Other - Middle Name:LEE
Other - Last Name:RAGGI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:11161 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2606
Mailing Address - Country:US
Mailing Address - Phone:301-593-6554
Mailing Address - Fax:
Practice Address - Street 1:11161 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2606
Practice Address - Country:US
Practice Address - Phone:301-593-6554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04713103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical