Provider Demographics
NPI:1174026629
Name:WASHINGTON, KAMERA (MS SLP)
Entity Type:Individual
Prefix:
First Name:KAMERA
Middle Name:
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 23RD ST UNIT 305
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-5921
Mailing Address - Country:US
Mailing Address - Phone:225-266-0677
Mailing Address - Fax:
Practice Address - Street 1:312 23RD ST UNIT 305
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-5921
Practice Address - Country:US
Practice Address - Phone:225-266-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA14907235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA14907OtherSPEECH-LANGUAGE PATHOLOGY