Individual
MRS. SUSAN KNAP WASSUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
915 COURT ST, LYNCHBURG, VA 24504-1603
(434) 515-5180
(434) 522-2323
Mailing address
915 COURT ST, LYNCHBURG, VA 24504-1603
(434) 515-5180
(434) 522-2323
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202007910
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202007910
VIRGINIA SPEECH-LANGUAGE PATHOLOGIST LICENSE
VA
Enumeration date
04/09/2019
Last updated
04/09/2019
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