Provider Demographics
NPI:1073646394
Name:VENEY-FREEMAN, EVELYN L (MSCCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:EVELYN
Middle Name:L
Last Name:VENEY-FREEMAN
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 WESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1850
Mailing Address - Country:US
Mailing Address - Phone:301-324-8388
Mailing Address - Fax:301-324-1281
Practice Address - Street 1:901 WESTLAKE DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1850
Practice Address - Country:US
Practice Address - Phone:301-324-8388
Practice Address - Fax:301-324-1281
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0112395235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist