Doctor Name: | LISA WALKER |
NPI Number: | 1255733887 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | 2202005075 |
Business Practice Address: | 11240 Waples Mill Rd Suite 101 Fairfax, VA - 220306078 |
Business Phone Number: | 7032372219 |
Business Fax Number: | 7032372729 |
Mailing Address: | 11240 Waples Mill Rd, Suite 101 FAIRFAX |
State: | VA |
Postal Code: | 220306078 |
Phone Number: | 7032372219 |
Fax Number: | 7032372729 |
NPI Enumeration Date: | 09/26/2014 |
NPI Last Update Date: | 09/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202005075 |
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 |