Healthcare Provider Details
I. General information
NPI: 1831005750
Provider Name (Legal Business Name): VERNISHA DARA HODGE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
VI MEDICAL FOUNDATION BUILDING, 9150 SUITE 106 & 108
ST. THOMAS VI
00802
US
IV. Provider business mailing address
PO BOX 9934
ST THOMAS VI
00801-2934
US
V. Phone/Fax
- Phone: 340-473-5924
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SLP200001893 |
| License Number State | DC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: