Individual
RACHEL LISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1722 LAWRENCEVILLE PLANK RD, LAWRENCEVILLE, VA 23868-3351
(434) 848-4766
(434) 848-6587
Mailing address
712 YORKSHIRE DR, VIRGINIA BEACH, VA 23452-5820
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005797
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202005797
ASHA 12129358
VA
Enumeration date
09/14/2012
Last updated
09/14/2012
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