Individual
LORI HAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1840 TAZEWELL AVE, BLUEFIELD, VA 24605-1125
(276) 326-1507
Mailing address
506 JEFFERSONVILLE ST, TAZEWELL, VA 24651-5396
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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