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General NPI Number Information
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NPI Number | 1851661367
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Entity Type | Individual
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Provider Name | LATEAKA SHERI VINSON M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/01/2012
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 2250 OLD BRICK RD SUITE 2229
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City | GLEN ALLEN
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State | VA
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Zip | 23060
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Country | US
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Telephone | 516-902-6713
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Fax |
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Provider Business Mailing Address
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Address Line | 2250 OLD BRICK RD SUITE 2229
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City | GLEN ALLEN
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State | VA
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Zip | 23060-5944
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Country | US
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Telephone | 516-902-6713
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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 | 20843
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License Number State | CA
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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 | 2202006448
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License Number State | VA
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