Individual
MRS. JENNIFER KAY WISTHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
5814 POST CORNERS TRL APT D, CENTREVILLE, VA 20120-6321
(773) 793-9681
Mailing address
5165 11TH ST S, ARLINGTON, VA 22204-3231
(703) 933-0297
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
05585
MD
235Z00000X
Speech-Language Pathologist
Primary
2202005231
VA
Other
Enumeration date
08/24/2007
Last updated
08/24/2007
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