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Individual

MS. SUSAN JOANNE MATTHEWS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699
Mailing address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004386
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
187839
BLUE CROSS BLUE SHIELD
VA
05
4978277
VA
Enumeration date
02/05/2007
Last updated
07/08/2007
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