Provider Demographics
NPI:1083229157
Name:KAUFMANN, VIRGINIA (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:KAUFMANN
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7916 STUART HALL RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6651
Mailing Address - Country:US
Mailing Address - Phone:804-512-1039
Mailing Address - Fax:
Practice Address - Street 1:5004 MONUMENT AVE STE 104
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3629
Practice Address - Country:US
Practice Address - Phone:804-512-1039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202005823235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist