Individual
JESSICA SAMPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
278 BROADWAY AVE, COALTON, WV 26257-6708
(304) 636-9150
Mailing address
278 BROADWAY AVE, COALTON, WV 26257-6708
(304) 636-9150
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2461
WV
Other
Enumeration date
04/26/2024
Last updated
04/26/2024
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