Provider Demographics
NPI:1134898133
Name:VAKHARIA, AMULYA CHANDRA
Entity type:Individual
Prefix:
First Name:AMULYA
Middle Name:CHANDRA
Last Name:VAKHARIA
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 1:5788 RICHARDS VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-7187
Mailing Address - Country:US
Mailing Address - Phone:301-503-9310
Mailing Address - Fax:
Practice Address - Street 1:5788 RICHARDS VALLEY RD
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-7187
Practice Address - Country:US
Practice Address - Phone:301-503-9310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06461235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist