Provider Demographics
NPI:1528268752
Name:BASYE, MAUREEN E (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:E
Last Name:BASYE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:MAUREEN
Other - Middle Name:E
Other - Last Name:BURNHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2869 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4512
Mailing Address - Country:US
Mailing Address - Phone:703-299-0051
Mailing Address - Fax:703-299-0052
Practice Address - Street 1:218 N LEE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-2660
Practice Address - Country:US
Practice Address - Phone:703-299-0051
Practice Address - Fax:703-299-0052
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004163235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist