Individual
MARY THERESE TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
4208 SEASIDE RD, EXMORE, VA 23350-2575
(757) 678-5151
Mailing address
PO BOX 294, EASTVILLE, VA 23347-0294
(757) 331-2712
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005905
VA
Other
Enumeration date
02/20/2018
Last updated
02/20/2018
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