| |
24430 Stone Springs Blvd., Suite 115, Dulles, VA 20166-2269 | |
(571) 707-2067 | |
(571) 209-1870 |
Full Name | |
---|---|
Type | Facility |
Speciality | Speech-language Pathologist |
Location | 24430 Stone Springs Blvd., Suite 115, Dulles, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962006726 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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224-d Cornwall Street, Nw, Suite 403, Leesburg, VA 20176-3346 Ph: (703) 737-6010 | 24430 Stone Springs Blvd., Suite 115, Dulles, VA 20166-2269 Ph: (571) 707-2067 |