Individual
GLENNA P CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
RR 5 BOX 20, GRUNDY, VA 24614-9611
(276) 935-1130
(276) 935-1538
Mailing address
RR 5 BOX 20, GRUNDY, VA 24614-9611
(276) 935-1130
(276) 935-1538
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202002503
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7401121000
—
WV
Enumeration date
03/06/2007
Last updated
07/09/2007
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