Emily Souther

Individual provider Active NPI Speech-Language Pathologist · Evans, WV

NPI 1215337175 · NPPES record last updated Aug 28, 2014

Key facts

NPI
1215337175
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
P/SLP-0616 (WV)
Practice address
410 Pine Dr
Evans, WV 25241-8112
Phone
(304) 532-3614
NPI assigned
Aug 28, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
P/SLP-0616WVMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X P/SLP-0616 WV Yes

Addresses

Primary practice location

410 Pine Dr
Evans, WV 25241-8112

Mailing address

410 Pine Dr
Evans, WV 25241-8112

Other providers in Evans, WV

All providers in Evans, WV · Speech-Language Pathologist in West Virginia

Sources for this page

Verify at the official NPI Registry.