Individual
LISSETTE DIALS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
8575 RIXLEW LN, MANASSAS, VA 20109-3701
(703) 257-9770
Mailing address
4074 WESTWIND DR, WOODBRIDGE, VA 22193-5168
(215) 692-0847
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202006443
VA
235Z00000X
Speech-Language Pathologist
SL009210
PA
Other
Enumeration date
11/14/2008
Last updated
03/17/2015
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