Organization
CHESTERFIELD SPEECH-LANGUAGE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN STOUGH M.ED., CCC-SLP (CO-OWNER)
(804) 677-6966
Entity
Organization
Contact information
Practice address
9311 SOUTHPORT DR, NORTH CHESTERFIELD, VA 23235-4933
(804) 677-6966
Mailing address
PO BOX 36307, NORTH CHESTERFIELD, VA 23235-8006
(804) 677-6966
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202002757
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202002757
VIRGINIA BOARD OF AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY
VA
Enumeration date
06/16/2015
Last updated
06/16/2015
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