Provider Demographics
NPI:1245874098
Name:RICHARDSON, VICTORIA KURR I (MS)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:KURR
Last Name:RICHARDSON
Suffix:I
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 WILGATE RD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3325
Mailing Address - Country:US
Mailing Address - Phone:203-241-5875
Mailing Address - Fax:
Practice Address - Street 1:3701 FERNHILL AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-6133
Practice Address - Country:US
Practice Address - Phone:203-241-5875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-05
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
MD09536235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD09536OtherMARYLAND DEPARTMENT OF HEALTH- SPEECH LANGUAGE PATHOLOGIST LICENSE
14128436OtherAMERICAN SPEECH LANGUAGE HEARING ASSOCIATION (ASHA)