Provider Demographics
NPI:1255093274
Name:BEACHAM, VALERIE ANN (AUD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:BEACHAM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 AUTUMNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20194-1521
Mailing Address - Country:US
Mailing Address - Phone:703-508-2167
Mailing Address - Fax:
Practice Address - Street 1:6845 ELM ST STE 303
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3834
Practice Address - Country:US
Practice Address - Phone:703-508-2167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001850231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist