Provider Demographics
NPI:1316176001
Name:ROUSH, KRISTIN CHOLEWA (PHD, CCC-A, F-AAA)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:CHOLEWA
Last Name:ROUSH
Suffix:
Gender:F
Credentials:PHD, CCC-A, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 EMMET STREET SOUTH
Mailing Address - Street 2:P O BOX 400270
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22904-4270
Mailing Address - Country:US
Mailing Address - Phone:434-924-7034
Mailing Address - Fax:434-924-4621
Practice Address - Street 1:417 EMMET STREET SOUTH
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22904-4270
Practice Address - Country:US
Practice Address - Phone:434-924-7034
Practice Address - Fax:434-924-4621
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1316176001OtherNPI