Provider Demographics
NPI:1700380599
Name:OCHOA, CAROLINE
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:OCHOA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:
Other - Last Name:OCHOA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:85 MELANIE HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2863
Mailing Address - Country:US
Mailing Address - Phone:757-269-8505
Mailing Address - Fax:
Practice Address - Street 1:60 GALLERY RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-8839
Practice Address - Country:US
Practice Address - Phone:540-658-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008020235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist