Individual
ETHEL LOUISE STREETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 LONDON BLVD, PORTSMOUTH, VA 23704-2199
(757) 393-5442
Mailing address
1801 LONDON BLVD, PORTSMOUTH, VA 23704-2199
(757) 393-5442
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2203000419
VA
Other
Enumeration date
04/10/2018
Last updated
06/16/2018
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