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Individual

SUSANNE M. VILA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
333 FOUNDRY ST, NEW MARTINSVILLE, WV 26155-1142
(304) 455-2441
(304) 455-3446
Mailing address
333 FOUNDRY ST, NEW MARTINSVILLE, WV 26155-1142
(304) 455-2441
(304) 455-3446

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
5332
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0889542000
WV
Enumeration date
12/05/2007
Last updated
12/05/2007
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