Healthcare Provider Details

I. General information

NPI: 1982901286
Provider Name (Legal Business Name): VANESSA ANNE TALBOTT CF-SLP, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2011
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 CAMERON PARKE CT
ALEXANDRIA VA
22304-6421
US

IV. Provider business mailing address

108 CAMERON PARKE CT
ALEXANDRIA VA
22304-6421
US

V. Phone/Fax

Practice location:
  • Phone: 706-358-2468
  • Fax:
Mailing address:
  • Phone: 706-358-2468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: