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Individual

BETTY J MANASCO

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
3910 OLD BUCKINGHAM RD, POWHATAN, VA 23139-5719
(804) 598-2200
(804) 598-3114
Mailing address
PO BOX 189, GOOCHLAND, VA 23063-0189
(804) 556-5400
(804) 556-5403

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202000808
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
106296
HEALTHKEEPERS
VA
01
10863
VALUE OPTIONS
VA
01
244010
MAMSI
VA
01
44157
SENTARA
VA
Enumeration date
05/27/2006
Last updated
07/08/2007
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