| NPI | 1649581422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACIE ANN FOX Owner 540-446-2654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202005910) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: VA 0119004724) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2018-03-15 |