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NPI Code Detail

MEDICARE: JASMINE MICHELLE RICHARDSON CCC-SLP

MEDICARE: JASMINE MICHELLE RICHARDSON CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2204001180VA

General Provider Information

NPI Number : 1023799442
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASMINE MICHELLE RICHARDSON CCC-SLP
Provider Business Mailing Address
First Line : 10051 FOXES WAY
Second Line :
City : KING GEORGE
State : VA
Zip : 22485-3458
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10051 FOXES WAY
Second Line :
City : KING GEORGE
State : VA
Zip : 22485-3458
Country : US
Telephone Number : 540-774-4263
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2023
Last Update Date : 06/04/2024

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Directions to “ JASMINE MICHELLE RICHARDSON CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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