Provider Demographics
NPI:1932663622
Name:RAMIREZ ARDON, SAMANTHA A (MA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:A
Last Name:RAMIREZ ARDON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-4641
Mailing Address - Country:US
Mailing Address - Phone:818-284-2161
Mailing Address - Fax:
Practice Address - Street 1:3600 SAUNDERS AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-4328
Practice Address - Country:US
Practice Address - Phone:804-665-1229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-26
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001195235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist