Provider Demographics
NPI:1598237059
Name:SEARCY, VANESSA (SLP)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:SEARCY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 QUEENS CHAPEL RD APT 118
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3632
Mailing Address - Country:US
Mailing Address - Phone:240-602-4492
Mailing Address - Fax:
Practice Address - Street 1:5101 PIERCE AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740-2599
Practice Address - Country:US
Practice Address - Phone:301-513-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01769L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14174006OtherASHA - AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION