Individual
MRS. CAROLYN MARIE KRUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC/SLP
Contact information
Practice address
1840 AMHERST ST, WINCHESTER, VA 22601-2808
(540) 536-1126
(540) 536-5139
Mailing address
4754 SENSENY RD, BERRYVILLE, VA 22611-3334
(540) 955-2224
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202002446
VA
235Z00000X
Speech-Language Pathologist
SLP-0435
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01065664
ASHA CERTIFICATION
—
05
—
0154326000
—
WV
01
—
2202002446
VA SLP LICENSE
VA
01
—
SLP-0435
WV SLP LICENSE
WV
Enumeration date
10/04/2006
Last updated
07/09/2007
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