Individual
MRS. MARIANNE K BARDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
19465 DEERFIELD AVE, SUITE 201, LANSDOWNE, VA 20176-8446
(703) 858-7620
Mailing address
19465 DEERFIELD AVE, SUITE 201, LANSDOWNE, VA 20176-8446
(703) 858-7620
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202001515
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4978196
—
VA
Enumeration date
05/11/2007
Last updated
06/11/2008
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