MEDICARE: ARIEL REBECCA FARREN 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	2202012292	VA
2	235Z00000X	Speech-Language Pathologist	2204001483	VA

General Provider Information

NPI Number	:	1932936242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIEL REBECCA FARREN CCC-SLP

Provider Business Mailing Address
First Line	:	421 WASHINGTON AVE SW APT 1
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24016-4232
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 2ND ST SW STE 202
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24016-4935
Country	:	US
Telephone Number	:	540-982-2208
Fax Number	:

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

Provider Enumeration Date	:	09/19/2024
Last Update Date	:	03/12/2026

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Directions to “ ARIEL REBECCA FARREN CCC-SLP” Practice Location

Language	Start Address	Practice Location

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