Individual
JESSICA LEIGH POGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ST
Contact information
Practice address
2875 BARN RD, SUITE 100, CHRISTIANSBURG, VA 24073-6389
(540) 639-5786
(540) 633-0787
Mailing address
2875 BARN RD, SUITE 100, CHRISTIANSBURG, VA 24073-6389
(540) 639-5786
(540) 633-0787
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22022005785
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487759957
ANTHEM
VA
05
—
1487759957
—
VA
Enumeration date
09/24/2009
Last updated
09/24/2009
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