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Individual

MRS. TONYA MARIE PALMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA CCC SLP

Contact information

Practice address
105 ADAIR STREET, BECKLEY, WV 25801
(304) 256-4500
(304) 256-4739
Mailing address
109 DEAN STREET, BECKLEY, WV 25801
(304) 253-4980

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP 0509
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9400167000
WV
Enumeration date
01/24/2008
Last updated
01/24/2008
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