Individual
OLGA GONCHAROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
43255 STILLFOREST TER., ASHBURN, VA 20147
(248) 470-5774
Mailing address
43255 STILLFOREST TER, ASHBURN, VA 20147-5138
(248) 470-5774
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006930
VA
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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