MEDICARE: CATHERINE DURHAM M.A., 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
1	235Z00000X	Speech-Language Pathologist	2202007626	VA

General Provider Information

NPI Number	:	1851814388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE DURHAM M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	4110 E PARHAM RD STE 101
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-2776
Country	:	US
Telephone Number	:	804-672-8588
Fax Number	:	804-672-8587

Provider Business Practice Location Address
First Line	:	4110 E PARHAM RD STE 101
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-2776
Country	:	US
Telephone Number	:	804-672-8588
Fax Number	:	804-672-8587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2017
Last Update Date	:	07/21/2022

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Directions to “ CATHERINE DURHAM M.A., CCC-SLP” Practice Location

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