Provider Demographics
NPI:1851507917
Name:GINN, TRICIA (MSP CCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:
Last Name:GINN
Suffix:
Gender:F
Credentials:MSP CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11820 BLANDFIELD ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-2425
Mailing Address - Country:US
Mailing Address - Phone:804-641-4548
Mailing Address - Fax:
Practice Address - Street 1:11820 BLANDFIELD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-2425
Practice Address - Country:US
Practice Address - Phone:804-641-4548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003119235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist