Individual
MS. WANDA J. BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
RR 2 BOX 169-G, GRAYROCK PROFESSIONAL PARK, LEWISBURG, WV 24901-9316
(304) 645-1706
(304) 645-4085
Mailing address
420 W PINHOOK RD, SUITE A, LAFAYETTE, LA 70503-2131
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-0001
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810006723
—
WV
Enumeration date
01/08/2007
Last updated
07/09/2007
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