Individual
JENNIFER DENISE FREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED. CCC-SLP/L
Contact information
Practice address
6920 BRADDOCK ROAD, SUITE B618, ANNANDALE, VA 22003
(703) 910-3321
(703) 663-7134
Mailing address
6920 BRADDOCK ROAD, SUITE B618, ANNANDALE, VA 22003
(703) 910-3321
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005653
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09141803
ASHA CERTIFICATION
—
01
—
2202005653
STATE LICENSE
VA
Enumeration date
05/12/2006
Last updated
07/21/2022
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