Provider Demographics
NPI:1184018749
Name:VERGE, RIAN
Entity Type:Individual
Prefix:MS
First Name:RIAN
Middle Name:
Last Name:VERGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 FLAGSTONE DR APT 1808
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2966
Mailing Address - Country:US
Mailing Address - Phone:256-348-1520
Mailing Address - Fax:
Practice Address - Street 1:2023 FLAGSTONE DR APT 1808
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2966
Practice Address - Country:US
Practice Address - Phone:256-348-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-22
Last Update Date:2015-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist