Individual
MRS. PAMELA MICHELLE CRECCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1936 OPITZ BLVD STE A, WOODBRIDGE, VA 22191-3360
(703) 543-9164
Mailing address
PO BOX 542, STAFFORD, VA 22555-0542
(252) 571-1419
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4744
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7411490
—
NC
Enumeration date
12/09/2011
Last updated
03/26/2020
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