Provider Demographics
NPI:1487114435
Name:MORAN, VASEANA D
Entity type:Individual
Prefix:
First Name:VASEANA
Middle Name:D
Last Name:MORAN
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 1:1001 3RD ST SW APT 612
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-4411
Mailing Address - Country:US
Mailing Address - Phone:502-533-5567
Mailing Address - Fax:
Practice Address - Street 1:1001 3RD ST SW APT 612
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-4411
Practice Address - Country:US
Practice Address - Phone:502-533-5567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-24
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist