Provider Demographics
NPI:1821323262
Name:KROUSKOP, ADRIENNE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:KROUSKOP
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1591 PORT REPUBLIC RD
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3517
Mailing Address - Country:US
Mailing Address - Phone:540-437-4226
Mailing Address - Fax:540-720-5660
Practice Address - Street 1:1591 PORT REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:VA
Practice Address - Zip Code:22801-3517
Practice Address - Country:US
Practice Address - Phone:540-437-4226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005744235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist