Individual
MS. MARY SHANNON BONK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
43618 CARRADOC FARM TER, LEESBURG, VA 20176-8232
(571) 333-3811
(571) 333-3811
Mailing address
43618 CARRADOC FARM TER, LEESBURG, VA 20176-8232
(571) 333-3811
(571) 333-3811
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202001042
VA
Other
Enumeration date
02/12/2009
Last updated
03/11/2009
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