Provider Demographics
NPI:1144719816
Name:TORQUATO, BRANDI RENEE (MS SLP)
Entity type:Individual
Prefix:MRS
First Name:BRANDI
Middle Name:RENEE
Last Name:TORQUATO
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:MS
Other - First Name:BRANDI
Other - Middle Name:RENEE
Other - Last Name:ANKENY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSLP
Mailing Address - Street 1:17217 OAK RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:RUTHER GLEN
Mailing Address - State:VA
Mailing Address - Zip Code:22546-4553
Mailing Address - Country:US
Mailing Address - Phone:804-867-7922
Mailing Address - Fax:
Practice Address - Street 1:9100 SAINT ANTHONYS RD
Practice Address - Street 2:
Practice Address - City:KING GEORGE
Practice Address - State:VA
Practice Address - Zip Code:22485-3413
Practice Address - Country:US
Practice Address - Phone:804-867-7922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2203000226235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty