Individual
J BERKELEY MCQUIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
415 S PROVIDENCE RD, NORTH CHESTERFIELD, VA 23236-3343
(804) 674-1310
Mailing address
8903 SIERRA RD, RICHMOND, VA 23229-7828
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204000289
VA
Other
Enumeration date
08/26/2019
Last updated
09/04/2020
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