National Provider Identifier
Kristin C Bergholtz, M.S., LIC.CCC-SLP
Kristin C Bergholtz, M.S., LIC.CCC-SLP is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Pittsford, NY and a listed phone number of (585) 260-7627.
Profile Overview
- NPI
- 1124114590
- Provider Type
- Individual
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- October 05, 2006
- Last Updated
- September 12, 2023
Practice Location
- 1151 Pittsford Victor RD Ste 103
- Pittsford, NY 14534-3829
Phone: (585) 260-7627
Specialties
- Speech-Language Pathologist (235Z00000X)
Full Record
- NPI
- 1124114590
- Entity Type
- Individual
- Last Name
- Bergholtz
- First Name
- Kristin
- Middle Name
- C
- Credential
- M.S., LIC.CCC-SLP
- Mailing Street Address
- 1151 Pittsford Victor RD Ste 103
- Mailing City
- Pittsford
- Mailing State
- NY
- Mailing ZIP Code
- 14534-3829
- Mailing Country
- US
- Mailing Phone
- (585) 260-7627
- Practice Street Address
- 1151 Pittsford Victor RD Ste 103
- Practice City
- Pittsford
- Practice State
- NY
- Practice ZIP Code
- 14534-3829
- Practice Country
- US
- Practice Phone
- (585) 260-7627
- Enumeration Date
- October 05, 2006
- Last Updated
- September 12, 2023
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- September 12, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Speech-Language Pathologist (235Z00000X)
- Other Identifiers
- 30-0213081 (NY, Tax Id)