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Individual

NANCY DEE AVERILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CC-SLP

Contact information

Practice address
20 WESTWOOD MEDICAL PARK, BLUEFIELD, VA 24605-2003
(276) 322-5439
Mailing address
12211 MEETINGHOUSE DR, CORNELIUS, NC 28031-4559
(660) 216-9859

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2005014671
MO
235Z00000X
Speech-Language Pathologist
Primary
2202009066
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992931216
MO
Enumeration date
06/01/2009
Last updated
03/12/2019
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