Provider Demographics
NPI:1306099114
Name:KREGER, AMY MARIE (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:MARIE
Last Name:KREGER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9906 HIDDEN DUNES LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5942
Mailing Address - Country:US
Mailing Address - Phone:407-484-8466
Mailing Address - Fax:
Practice Address - Street 1:9906 HIDDEN DUNES LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-5942
Practice Address - Country:US
Practice Address - Phone:407-484-8466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 9135235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist