Provider Demographics
NPI:1538572409
Name:FORDE OSBORNE, VELMA (SLP)
Entity type:Individual
Prefix:MRS
First Name:VELMA
Middle Name:
Last Name:FORDE OSBORNE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:VELMA
Other - Middle Name:L
Other - Last Name:FORDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:405 W 238TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2208
Mailing Address - Country:US
Mailing Address - Phone:718-548-1872
Mailing Address - Fax:
Practice Address - Street 1:405 W 238TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2208
Practice Address - Country:US
Practice Address - Phone:718-548-1872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-08
Last Update Date:2014-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005642-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist