Individual
MRS. JEANNINE MARIE LAFFERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
351 E MAIN ST, BRIDGEPORT, WV 26330-1845
(304) 933-3073
(304) 933-3187
Mailing address
351 E MAIN ST, BRIDGEPORT, WV 26330-1845
(304) 933-3073
(304) 933-3187
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810002019
—
WV
Enumeration date
05/21/2007
Last updated
02/01/2012
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