Provider Demographics
NPI:1538834890
Name:REDFORD, ELIZABETH CAROL (CF-SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CAROL
Last Name:REDFORD
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3445 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1429
Mailing Address - Country:US
Mailing Address - Phone:434-294-0059
Mailing Address - Fax:
Practice Address - Street 1:9450 ATLEE STATION RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2600
Practice Address - Country:US
Practice Address - Phone:804-723-2160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000658235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist