Individual
JENNIFER WILLIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2007 MEADE PKWY, SUFFOLK, VA 23434-4259
(757) 539-6300
(757) 539-0704
Mailing address
2007 MEADE PKWY, SUFFOLK, VA 23434-4259
(757) 539-6300
(757) 539-0704
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202003715
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004979796
—
VA
Enumeration date
07/14/2008
Last updated
07/14/2008
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