| NPI | 1083818017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON FORE Hr Generalist 703-924-4122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202004710) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-22 |