Individual
ANDREA RICHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
47 SOUTHWIND DR, BURLINGTON, VT 05401-5476
(802) 233-6704
Mailing address
47 SOUTHWIND DR, BURLINGTON, VT 05401-5476
(802) 233-6704
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
144.0116238
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12055901
AMERICAN SPEECH HEARING AND LANGUAGE ASSOCIATION CERTIFICATION
—
01
—
144.0116238
STATE OF VERMONT SPEECH LANGUAGE PATHOLOGIST LICENSE
VT
Enumeration date
07/24/2017
Last updated
07/24/2017
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