Provider Demographics
NPI:1235554643
Name:RAZO, PATRICIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:RAZO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 MILESTONE WAY
Mailing Address - Street 2:APT G006
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740-4252
Mailing Address - Country:US
Mailing Address - Phone:240-438-4395
Mailing Address - Fax:
Practice Address - Street 1:9600 MILESTONE WAY
Practice Address - Street 2:APT G006
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-4252
Practice Address - Country:US
Practice Address - Phone:240-438-4395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07083235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist