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Individual
KRISTIN C BERGHOLTZ
Active
Individual
KRISTIN C BERGHOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LIC. CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015715-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30-0213081
TAX ID
NY
Enumeration date
10/05/2006
Last updated
03/21/2026
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