Individual
SYDNI LAWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 BROAD ROCK BLVD, RICHMOND, VA 23224-4924
(804) 562-7307
Mailing address
5900 MIDDLEFIELD LN, CHESTERFIELD, VA 23832-7595
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204001524
VA
Other
Enumeration date
11/14/2024
Last updated
11/14/2024
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