Individual
MARY BLAKE HINSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5301 PROVIDENCE RD STE 80, VIRGINIA BEACH, VA 23464-4128
(757) 467-4604
(757) 467-4604
Mailing address
4668 PEMBROKE BLVD STE 115, VIRGINIA BEACH, VA 23455-6423
(757) 648-8562
(757) 648-8564
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008532
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202008532
VIRGINIA LICENSE
VA
Enumeration date
07/14/2017
Last updated
07/14/2017
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