Individual
LAURA CRISLER GRESHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
6063 RIVER CRES, NORFOLK, VA 23505-4706
(757) 777-2420
Mailing address
6063 RIVER CRES, NORFOLK, VA 23505-4706
(757) 777-2420
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006145
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12096443
AMERICAN SPEECH LANGUAGE AND HEARING ASSOCIATION CERTIFICATION
—
01
—
2202006145
VA SPEECH LANGUAGE PATHOLOGY LICENSE
VA
Enumeration date
10/27/2010
Last updated
02/02/2024
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