Organization
EVOLVE PEDIATRIC THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL MAUCK M.A. CCC-SLP (CO-OWNER/SLP)
(304) 268-7353
Entity
Organization
Contact information
Practice address
164 RAWHIDE LN, SHENANDOAH JUNCTION, WV 25442-4817
(304) 582-5320
Mailing address
164 RAWHIDE LN, SHENANDOAH JUNCTION, WV 25442-4817
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
12/01/2023
Last updated
07/11/2024
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