Individual
MRS. NITA PUTNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
14715 BRISTOW RD, MANASSAS, VA 20112-3945
(703) 586-9929
Mailing address
14708 PARSON WEEMS LOOP, WOODBRIDGE, VA 22193-3260
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202007632
VA
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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