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General NPI Number Information
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NPI Number | 1952651366
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Entity Type | Individual
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Provider Name | KRISTEN NICOLE PIZZOFERRATO MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 3940 PRINCE WILLIAM PKWY
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4513
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Country | US
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Telephone | 703-670-9568
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Fax |
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Provider Business Mailing Address
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Address Line | 644 S NEWKIRK ST
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City | BALTIMORE
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State | MD
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Zip | 21224-4414
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Country | US
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Telephone | 740-317-9815
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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 | SL011014
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202006862
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 09090
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License Number State | MD
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