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General NPI Number Information
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NPI Number | 1013147651
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Entity Type | Individual
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Provider Name | DAPHNE RICHMOND
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Gender | Female
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 07/16/2009
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Provider Practice Location Address
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Address Line | 6434 DALE DR
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City | MARION
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State | MS
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Zip | 39342-8704
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Country | US
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Telephone | 601-483-4285
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Fax |
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Provider Business Mailing Address
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Address Line | 11301 CORPORATE BLVD SUITE 101
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City | ORLANDO
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State | FL
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Zip | 32817-8354
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | S3378
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License Number State | MS
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