Individual
MICHAEL ALLYSON EADES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12997 NETTLES DR, NEWPORT NEWS, VA 23602-6913
(757) 249-8880
Mailing address
12997 NETTLES DR, NEWPORT NEWS, VA 23602-6913
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008089
VA
Other
Enumeration date
01/18/2016
Last updated
01/18/2016
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