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General NPI Number Information
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NPI Number | 1689306995
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Entity Type | Individual
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Provider Name | MIRANDA BRITTANY VELASQUEZ
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Gender | Female
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Dates
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Enumeration Date | 06/27/2022
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 8986 LORTON STATION BLVD
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City | LORTON
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State | VA
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Zip | 22079-4753
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Country | US
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Telephone | 571-616-9579
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Fax |
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Provider Business Mailing Address
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Address Line | 4308 STAR LN
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City | ROCKVILLE
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State | MD
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Zip | 20852-2430
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Country | US
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Telephone | 301-525-1464
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 2201001967
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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