Provider Demographics
NPI:1922143049
Name:HAIRSTON, VERONICA D (SLP)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:D
Last Name:HAIRSTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 QUAIL MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1991
Mailing Address - Country:US
Mailing Address - Phone:513-423-9496
Mailing Address - Fax:513-727-3806
Practice Address - Street 1:872 62ND STREET CIR E STE 101-103
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-6238
Practice Address - Country:US
Practice Address - Phone:941-251-6825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP4296235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist