Doctor Name: | LISA RUBIN BULL |
NPI Number: | 1639482771 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 2202002478 |
Business Practice Address: | 1604 Spring Hill Rd Suite 310 Vienna, VA - 221827510 |
Business Phone Number: | 7035468594 |
Business Fax Number: | |
Mailing Address: | 2500 Tallyrand Ct, HERNDON |
State: | VA |
Postal Code: | 201712700 |
Phone Number: | 7039250118 |
Fax Number: | 7039250118 |
NPI Enumeration Date: | 07/19/2010 |
NPI Last Update Date: | 07/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202002478 |
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 |