MEDICARE: MARIEFE GUANLAO CAFUIR CCC-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	2202008244	VA

General Provider Information

NPI Number	:	1932792116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIEFE GUANLAO CAFUIR CCC-SLP

Provider Business Mailing Address
First Line	:	209 VERDE ST
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-4419
Country	:	US
Telephone Number	:	757-650-7478
Fax Number	:

Provider Business Practice Location Address
First Line	:	4176 S PLAZA TRL STE 217
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1920
Country	:	US
Telephone Number	:	757-401-4435
Fax Number	:

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

Provider Enumeration Date	:	02/18/2021
Last Update Date	:	02/18/2021

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Directions to “ MARIEFE GUANLAO CAFUIR CCC-SLP” Practice Location

Language	Start Address	Practice Location

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