Provider Demographics
NPI:1790717056
Name:KRUEGER, GINA GIORDANA (MS CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:GIORDANA
Last Name:KRUEGER
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 COURT ST
Mailing Address - Street 2:
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014
Mailing Address - Country:US
Mailing Address - Phone:920-849-1400
Mailing Address - Fax:
Practice Address - Street 1:206 COURT ST
Practice Address - Street 2:
Practice Address - City:CHILTON
Practice Address - State:WI
Practice Address - Zip Code:53014
Practice Address - Country:US
Practice Address - Phone:920-849-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146007454235Z00000X
WI2938-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist