Provider Demographics
NPI:1841398328
Name:ANDERSON, VELMA F (MED, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:VELMA
Middle Name:F
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 HEDGES STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44902
Mailing Address - Country:US
Mailing Address - Phone:419-774-4290
Mailing Address - Fax:419-774-4375
Practice Address - Street 1:255 HEDGES STREET
Practice Address - Street 2:SUITE A
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44902
Practice Address - Country:US
Practice Address - Phone:419-774-4290
Practice Address - Fax:419-774-4375
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP4402235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH43670124900OtherBUREAU OF WORK COMP
000000125376OtherANTHEM
3407897499240OtherANTHEM