Individual
SHANNON DEPRADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40487 BANSHEE DR, LEESBURG, VA 20175-7503
(703) 850-5301
Mailing address
40487 BANSHEE DR, LEESBURG, VA 20175-7503
(703) 779-4926
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004233
VA
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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