Myranda Noelle Victoria, PHD, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3048 Issued in AR

Practice address

3511 N. Silent Grove Rd.
Springdale, AR 72762-7913

Phone

(479) 750-8775

Fax

(855) 222-5520

NPI assigned

Jun 16, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Myranda Noelle Weese Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1932494036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 N. SILENT GROVE RD.",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727627913",
            "telephone_number": "479-750-8775",
            "fax_number": "855-222-5520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 N. SILENT GROVE RD.",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727627913",
            "telephone_number": "479-750-8775",
            "fax_number": "855-222-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTORIA",
        "first_name": "MYRANDA",
        "middle_name": "NOELLE",
        "name_prefix": "Mrs.",
        "credential": "PHD, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "3048",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "P8401",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186790721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRANDA",
            "last_name": "WEESE",
            "middle_name": "NOELLE",
            "credential": "MA, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teres Vendel, RN
• Kathryn Joan Venema, RPT,MS
• Mildred Verdin
• Verity Revenue, Inc.
• Dee Anna Vice
• Jasmyne J Villarruel
• Jessica Villere
• Edward Bradley Vinson, CNIM
• Sidney L Vinson, MD
• Dayton Heath Vire, PHARMD

• Speech-Language Pathologist in Springdale, AR
• Providers in Springdale, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.