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General NPI Number Information
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NPI Number | 1982202040
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Entity Type | Organization
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Legal Business Name | NORTHERN NECK REGIONAL SPECIAL EDUCATION PROGRAM
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 6914 RICHMOND RD
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City | WARSAW
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State | VA
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Zip | 22572-3547
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Country | US
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Telephone | 804-333-6557
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1507
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City | WARSAW
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State | VA
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Zip | 22572-1507
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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 | SPEECH LANGUAGE PATHOLOGIST
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Name | VIOLA THOMPSON
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Credential | M.S. CF-SLP
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Telephone | 804-761-0276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Q00000X
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Taxonomy Name | Pathology Specialist/Technologist
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License Number |
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License Number State |
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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 |
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License Number State |
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