MEDICARE: MRS. LORETTA PARHAM-FRIDAY MA-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2202004795	VA

General Provider Information

NPI Number	:	1376031286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORETTA PARHAM-FRIDAY MA-SLP

Provider Business Mailing Address
First Line	:	823 PHILPOT RD
Second Line	:
City	:	LOCUST HILL
State	:	VA
Zip	:	23092-9746
Country	:	US
Telephone Number	:	804-758-2496
Fax Number	:

Provider Business Practice Location Address
First Line	:	823 PHILPOT RD
Second Line	:
City	:	LOCUST HILL
State	:	VA
Zip	:	23092-9746
Country	:	US
Telephone Number	:	804-758-2496
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2018
Last Update Date	:	04/26/2018

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Directions to “ MRS. LORETTA PARHAM-FRIDAY MA-SLP” Practice Location

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