Provider Demographics
NPI:1336890607
Name:FERST, MADISON MARIE (MS, CF-SLP)
Entity Type:Individual
Prefix:MS
First Name:MADISON
Middle Name:MARIE
Last Name:FERST
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 SUMMIT POINT DR
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-4810
Mailing Address - Country:US
Mailing Address - Phone:540-622-7590
Mailing Address - Fax:
Practice Address - Street 1:200 SKILES BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7321
Practice Address - Country:US
Practice Address - Phone:610-455-4055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000702235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist