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Individual

LORELEI LASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9109 GLENBROOK RD, FAIRFAX, VA 22031-3008
(703) 261-9491
(276) 409-6203
Mailing address
9109 GLENBROOK RD, FAIRFAX, VA 22031-3008

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305004404
VA
2251P0200X
Pediatric Physical Therapist
Primary
2305004404
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004979907
VA
Enumeration date
04/17/2007
Last updated
03/05/2024
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