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General NPI Number Information
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NPI Number | 1801678735
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Entity Type | Individual
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Provider Name | ATHANASIA KYRIAZIS
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Gender | Female
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Dates
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Enumeration Date | 10/16/2023
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 4140 OLD WASHINGTON RD
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City | WALDORF
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State | MD
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Zip | 20602-3221
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Country | US
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Telephone | 310-645-2813
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Fax |
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Provider Business Mailing Address
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Address Line | 9906 AURA AVE APT SUITE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-1101
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Country | US
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Telephone | 818-885-8410
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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 | 11786
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202012092
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 34309
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License Number State | CA
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