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Individual

VIRGINIA BURNSIDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
239 COURT AVE, WESTON, WV 26452-2099
(304) 624-6554
(304) 624-5223
Mailing address
1201 N 15TH ST, CLARKSBURG, WV 26301-1989
(304) 624-6554
(304) 624-5223

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1808
WV

Other

Enumeration date
08/28/2017
Last updated
08/28/2017
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