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1972847192
LISA KNIERIM IVANOV
MANASSAS, VA
NPI
1972847192
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: VA 2202006805)
Enumeration Date
2012-11-15
Last Update Date
2013-03-21
Business Address
Mrs. LISA KNIERIM IVANOV CCC/SLP
8575 RIXLEW LN
MANASSAS, VA 20109-3701
Phone number: 703-257-2941
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Mailing Address
Mrs. LISA KNIERIM IVANOV CCC/SLP
24476 RIPPLE CT
ALDIE, VA 20105-5503
Phone number: 904-703-9310
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