Provider Demographics
NPI:1003328436
Name:FARRELL, NANCY WILLIAMS (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:WILLIAMS
Last Name:FARRELL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MERIWETHER AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23222-1332
Mailing Address - Country:US
Mailing Address - Phone:804-228-2720
Mailing Address - Fax:
Practice Address - Street 1:500 MERIWETHER AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23222-1332
Practice Address - Country:US
Practice Address - Phone:804-228-2720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202001459235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist