Individual
LUCILLE TEDESCO WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC/SLP
Contact information
Practice address
13 S HIGH ST, MORGANTOWN, WV 26501-7546
(304) 624-6554
(304) 624-5223
Mailing address
13 S HIGH ST, MORGANTOWN, WV 26501-7546
(304) 624-6554
(304) 624-5223
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0152680000
—
WV
Enumeration date
03/12/2008
Last updated
03/12/2008
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