Individual
GWENEVERE MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5102 OLYMPIA CT, SUFFOLK, VA 23435-3300
(757) 483-0120
Mailing address
5102 OLYMPIA CT, SUFFOLK, VA 23435-3300
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004959
VA
Other
Enumeration date
07/24/2013
Last updated
07/24/2013
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