Individual
MASON ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
39 BANK ST, CHATHAM, VA 24531-1129
(434) 432-2761
(434) 432-2893
Mailing address
7780 RENAN RD, HURT, VA 24563-2077
(434) 841-7405
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010448
VA
235Z00000X
Speech-Language Pathologist
2204000684
VA
Other
Enumeration date
08/12/2021
Last updated
09/05/2023
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