Healthcare Provider Details

I. General information

NPI: 1568443497
Provider Name (Legal Business Name): NEW BEGINNINGS THERAPY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 03/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 LAVENDER TRCE
HAMPTON VA
23663-1193
US

IV. Provider business mailing address

11 LAVENDER TRCE
HAMPTON VA
23663-1193
US

V. Phone/Fax

Practice location:
  • Phone: 757-329-1321
  • Fax: 757-788-8395
Mailing address:
  • Phone: 757-329-1321
  • Fax: 757-788-8395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number2202003588
License Number StateVA

VIII. Authorized Official

Name: MS. RANASHIA MARCHEA WILSON
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: M.A., CCC-SLP
Phone: 757-329-1321