Provider Demographics
NPI:1649901406
Name:KRESS, MADISON VICTORIA (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:VICTORIA
Last Name:KRESS
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 RIVERWOOD LN APT J
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5309
Mailing Address - Country:US
Mailing Address - Phone:404-661-0428
Mailing Address - Fax:404-937-2983
Practice Address - Street 1:11285 ELKINS RD STE G2
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1259
Practice Address - Country:US
Practice Address - Phone:678-824-2145
Practice Address - Fax:404-937-2983
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET003614235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist