Provider Demographics
NPI:1083395156
Name:AMEND, DELANIE MARIE (CF-SLP)
Entity Type:Individual
Prefix:
First Name:DELANIE
Middle Name:MARIE
Last Name:AMEND
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2410 NORTONIA RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-3355
Mailing Address - Country:US
Mailing Address - Phone:703-577-5648
Mailing Address - Fax:
Practice Address - Street 1:9900 KRAUSE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6535
Practice Address - Country:US
Practice Address - Phone:804-748-1405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001106235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist