Individual
MRS. STEPHANIE MACY RICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1413 LASKIN RD, VIRGINIA BEACH, VA 23451-6007
(757) 263-2800
Mailing address
1413 LASKIN RD, VIRGINIA BEACH, VA 23451-6007
(757) 263-2800
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005882
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14036346
ASHA CCC
—
01
—
2202005882
VIRGINIA SLP LICENSE
VA
Enumeration date
01/12/2010
Last updated
02/28/2013
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