Provider Demographics
NPI:1144487265
Name:RICE, VANDA LAURA
Entity type:Individual
Prefix:MRS
First Name:VANDA
Middle Name:LAURA
Last Name:RICE
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 1:8212 HIGHWAY 638
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-7242
Mailing Address - Country:US
Mailing Address - Phone:606-598-7274
Mailing Address - Fax:606-599-2389
Practice Address - Street 1:8212 HIGHWAY 638
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962-7242
Practice Address - Country:US
Practice Address - Phone:606-598-7274
Practice Address - Fax:606-599-2389
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0929235Z00000X
KY235Z00000X235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist