Healthcare Provider Details

I. General information

NPI: 1033409818
Provider Name (Legal Business Name): VERONICA P FARRIOR CCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VERONICA S PRIDE

II. Dates (important events)

Enumeration Date: 04/13/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4922B LASALLE RD
HYATTSVILLE MD
20782-3302
US

IV. Provider business mailing address

4922B LASALLE RD
HYATTSVILLE MD
20782-3302
US

V. Phone/Fax

Practice location:
  • Phone: 301-864-2333
  • Fax: 877-828-2060
Mailing address:
  • Phone: 301-864-2333
  • Fax: 877-828-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP007346
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: