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Individual

MRS. EMILY H WYCOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED.,CCC-SLP

Contact information

Practice address
2030 COLONIAL AVE SW, ROANOKE, VA 24015-3204
(540) 343-0165
(540) 345-4664
Mailing address
2030 COLONIAL AVE SW, ROANOKE, VA 24015-3204
(540) 343-0165
(540) 345-4664

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202001523
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007790506
AETNA
VA
01
195185
ANTHEM
VA
01
240052
MAMSI
VA
Enumeration date
10/27/2006
Last updated
07/08/2007
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