Provider Demographics
NPI:1376031286
Name:PARHAM-FRIDAY, LORETTA (MA-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LORETTA
Middle Name:
Last Name:PARHAM-FRIDAY
Suffix:
Gender:F
Credentials:MA-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 PHILPOT RD
Mailing Address - Street 2:
Mailing Address - City:LOCUST HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23092-9746
Mailing Address - Country:US
Mailing Address - Phone:804-758-2496
Mailing Address - Fax:
Practice Address - Street 1:823 PHILPOT RD
Practice Address - Street 2:
Practice Address - City:LOCUST HILL
Practice Address - State:VA
Practice Address - Zip Code:23092-9746
Practice Address - Country:US
Practice Address - Phone:804-758-2496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004795235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist