| NPI | 1942603881 |
|---|---|
| Doing Business As | SLC LOUDOUN |
| Entity Type | Organization |
| Authorized Contact | GORDY ROGERS Owner 917-628-7525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202006730) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2023-01-13 |