Individual
ADDIE ROSE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
313 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1205
(304) 746-3704
Mailing address
313 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1205
(304) 746-3704
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2417
WV
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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