Individual
NICOLE ELIZABETH HERNDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
11150 FAIRFAX BLVD, SUITE 500, FAIRFAX, VA 22030-5066
(703) 537-0373
(703) 865-7379
Mailing address
11150 FAIRFAX BLVD, SUITE 500, FAIRFAX, VA 22030-5066
(703) 537-0373
(703) 865-7379
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202007760
VA
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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