Individual
DARYA KHODADOUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
47426 RIVERBANK FOREST PL, STERLING, VA 20165-3169
(301) 919-9492
Mailing address
47426 RIVERBANK FOREST PL, STERLING, VA 20165-3169
(301) 919-9492
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2202011379
VA
235Z00000X
Speech-Language Pathologist
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202011379
LICENSE
VA
Enumeration date
08/11/2023
Last updated
11/18/2024
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