Individual
REBECCA PETERS TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC/SLP
Contact information
Practice address
132 ELF WAY, CLEAR BROOK, VA 22624-1489
(304) 886-1826
Mailing address
132 ELF WAY, CLEAR BROOK, VA 22624-1489
(304) 886-1826
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2202004757
VA
235Z00000X
Speech-Language Pathologist
Primary
SLP-0724
WV
Other
Enumeration date
05/02/2010
Last updated
07/09/2024
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