Individual
JENIFER M SHOCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
43453 PARISH ST, SOUTH RIDING, VA 20152-2522
(703) 327-1588
Mailing address
43453 PARISH ST, SOUTH RIDING, VA 20152-2522
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202003982
VA
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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