Provider Demographics
NPI:1700011483
Name:KROESEN, VALERIE ANN (MS CCC-SLP NBTC)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:ANN
Last Name:KROESEN
Suffix:
Gender:F
Credentials:MS CCC-SLP NBTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 SWEETWATER DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-4707
Mailing Address - Country:US
Mailing Address - Phone:843-559-4588
Mailing Address - Fax:843-899-8890
Practice Address - Street 1:1035 SWEETWATER DR
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-4707
Practice Address - Country:US
Practice Address - Phone:843-559-4588
Practice Address - Fax:843-899-8890
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-25
Last Update Date:2009-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4470235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist