Doctor Name: | AMY LYNN HASSELKUS |
NPI Number: | 1104861749 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 2202004304 |
Business Practice Address: | 4808 Allenby Rd Fairfax, VA - 220322301 |
Business Phone Number: | 7034255933 |
Business Fax Number: | 3018977354 |
Mailing Address: | 4808 Allenby Rd, FAIRFAX |
State: | VA |
Postal Code: | 220322301 |
Phone Number: | 7034255933 |
Fax Number: | 3018977354 |
NPI Enumeration Date: | 06/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202004304 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |