Provider Demographics
NPI:1831325604
Name:RICHARDS, MARCIA ANGELA (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:MARCIA
Middle Name:ANGELA
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 DUTCH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-4247
Mailing Address - Country:US
Mailing Address - Phone:516-285-6234
Mailing Address - Fax:
Practice Address - Street 1:2035 DUTCH BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-4247
Practice Address - Country:US
Practice Address - Phone:516-285-6234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-06
Last Update Date:2009-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010399-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist