Individual
MARY ELIZABETH VIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2865 E MAIN ST, HUMBOLDT, TN 38343-3070
(731) 784-5817
Mailing address
27 DEER CREEK CV, JACKSON, TN 38305-6600
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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