Individual
MICHELLE W RICHARDSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1912 MEMORIAL AVE, LYNCHBURG, VA 24501-1708
(434) 845-8765
Mailing address
2824 EVERGREEN RD, LYNCHBURG, VA 24503-3256
(434) 845-8765
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202003497
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216946
ANTHEM PROVIDER NUMBERS
VA
Enumeration date
04/05/2006
Last updated
07/08/2007
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