Jennifer Clark Baucom MA, CCC-SLP

NPI 1386854016 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1386854016
Gender Female
Enumeration Date 05/23/2007
Last Updated 07/27/2010
Entity Type Individual
Active Over 9 years ago
Practice Location
6688 MAIN ST
GLOUCESTER VA, 23061-5194, US
Phone (804) 210-1555
Fax
Business Location
PO BOX 130
GLOUCESTER VA, 23061-0130, US
Phone (804) 210-1555
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State Virginia
License Number 2202003940
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According to our database, Mrs. Jennifer Clark Baucom MA, CCC-SLP NPI is 1386854016, taxonomy code is 235Z00000X and license number is 2202003940, license state is located at Virginia. Jennifer Clark Baucom MA, CCC-SLP physically located at 6688 Main St, Gloucester VA, 23061-5194. NPI Number Jennifer Clark Baucom MA, CCC-SLP has the Individual type.

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1386854016 NPI number is provided on an as is basis without warranty of any kind. 1386854016 is maintained by the National Plan & Provider Enumeration System. The contents of Jennifer Clark Baucom MA, CCC-SLP are for informational purposes only.