Provider Demographics
NPI:1710138581
Name:MASDEN, VERONICA SUE
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:SUE
Last Name:MASDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5635 BRANDENBURG RD
Mailing Address - Street 2:
Mailing Address - City:LEITCHFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42754-7533
Mailing Address - Country:US
Mailing Address - Phone:270-259-2470
Mailing Address - Fax:
Practice Address - Street 1:5635 BRANDENBURG RD
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-7533
Practice Address - Country:US
Practice Address - Phone:270-230-5441
Practice Address - Fax:270-259-0307
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist