Individual
SUSAN QUINN LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCC/SLP
Contact information
Practice address
201 N COURT ST, GLENVILLE, WV 26351-1216
(304) 462-7386
(304) 462-5103
Mailing address
201 N COURT ST, GLENVILLE, WV 26351-1216
(304) 462-7386
(304) 462-5103
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0155220000
—
WV
Enumeration date
02/08/2008
Last updated
02/08/2008
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