Individual
ALLISON MABRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 NEVILLE ST, BECKLEY, WV 25801-4511
(304) 256-4712
Mailing address
400 NEVILLE ST, BECKLEY, WV 25801-4511
(304) 256-4712
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12056860
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810010082
—
WV
Enumeration date
04/23/2008
Last updated
04/23/2008
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