123grow

NPI 1043580715 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1043580715
Enumeration Date 01/11/2012
Last Updated 01/11/2012
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name SUSAN SUSAN
Position SPEECH PATHOLOGIST
Phone (304) 412-4246
Fax
Practice Location
624 SOUTH TER
HUNTINGTON WV, 25705-1511, US
Phone (304) 412-4246
Fax
Business Location
624 SOUTH TER
HUNTINGTON WV, 25705-1511, US
Phone (304) 412-4246
Fax
Toxanomy
Taxonomy Code 235Z00000X
License State West Virginia
License Number SLP-0802
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According to our database, 123grow NPI is 1043580715, taxonomy code is 235Z00000X and license number is SLP-0802, license state is located at West Virginia. 123grow physically located at 624 South Ter, Huntington WV, 25705-1511. NPI Number 1033115704 has the healthcare provider type.

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1043580715 NPI number is provided on an as is basis without warranty of any kind. 1043580715 is maintained by the National Plan & Provider Enumeration System. The contents of 123grow are for informational purposes only.