| NPI | 1013263037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA BEAVERS Speech Language Pathologist 757-345-3329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202004986) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2012-07-27 |