Individual
MS. KRISTINA RENEE PEGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.CCC-SLP
Contact information
Practice address
3540 VICTORY BLVD, YORKTOWN, VA 23693
(757) 776-0736
(757) 776-0737
Mailing address
3540 VICTORY BLVD, YORKTOWN, VA 23693-3641
(757) 776-0736
(757) 776-0737
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
2202004684
VA
235Z00000X
Speech-Language Pathologist
Primary
2202004684
VA
Other
Enumeration date
12/13/2007
Last updated
07/03/2024
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