Individual
LISA SUZANNE MATHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC
Contact information
Practice address
14715 BRISTOW RD, MANASSAS, VA 20112-3945
(703) 791-2099
Mailing address
9277 ELK RUN RD, CATLETT, VA 20119-2024
(703) 586-7040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004970
VA
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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