Doctor Name: | MRS. CORNELIA HAWKINS LONG |
NPI Number: | 1760684450 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 2202004350 |
Business Practice Address: | 2544 Port Potomac Ave Woodbridge, VA - 221911464 |
Business Phone Number: | 7034091822 |
Business Fax Number: | 7036708923 |
Mailing Address: | 2544 Port Potomac Ave, WOODBRIDGE |
State: | VA |
Postal Code: | 221911464 |
Phone Number: | 7034091822 |
Fax Number: | 7036708923 |
NPI Enumeration Date: | 06/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202004350 |
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 |