Individual
MARY SACKFIELD PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
21000 EDUCATION CT, BROADLANDS, VA 20148-5526
(703) 517-9614
Mailing address
21000 EDUCATION CT, BROADLANDS, VA 20148-5526
(703) 517-9614
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202002614
VA
Other
Enumeration date
03/25/2018
Last updated
03/25/2018
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