Individual
TAYLA GRACE CLARK MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
U
Contact information
Practice address
17507 LEE HWY, ABINGDON, VA 24210
(276) 525-1338
Mailing address
507 LAMONT STREET APT 2, JOHNSON CITY, TN 37604
(423) 946-8771
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204001374
VA
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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