Provider Demographics
NPI:1689995128
Name:BICE, ED M (CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:ED
Middle Name:M
Last Name:BICE
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21121 VANCES MILL RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-6959
Mailing Address - Country:US
Mailing Address - Phone:276-628-5521
Mailing Address - Fax:
Practice Address - Street 1:21121 VANCES MILL RD
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-6959
Practice Address - Country:US
Practice Address - Phone:276-628-5521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004743235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist