Individual
KATHLEEN NICOLE WIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CF-SLP
Contact information
Practice address
5604 VIRGINIA BEACH BLVD STE 101, VIRGINIA BEACH, VA 23462-5631
(757) 455-5000
Mailing address
5604 VIRGINIA BEACH BLVD STE 101, VIRGINIA BEACH, VA 23462-5631
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008604
VA
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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