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General NPI Number Information
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NPI Number | 1467331322
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Entity Type | Individual
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Provider Name | KEVIN SCOTT KRUEGER MA CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 2400 17TH ST
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City | COLUMBUS
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State | IN
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Zip | 47201-5351
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Country | US
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Telephone | 812-375-3815
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Fax |
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Provider Business Mailing Address
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Address Line | 12441 WILLOW BND
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City | ELIZABETHTOWN
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State | IN
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Zip | 47232-9352
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Country | US
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Telephone | 812-341-8034
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2201580A
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License Number State | IN
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