Individual
LISA M HAZLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
195 KANE STREET, GATE CITY, VA 24251
(276) 386-2424
(276) 386-1446
Mailing address
PO BOX 1807, GATE CITY, VA 24251-4807
(276) 386-2424
(276) 386-1446
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004203
VA
Other
Enumeration date
04/16/2008
Last updated
04/16/2008
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