Individual
CHRISTINE S KOPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-4961
(703) 792-5699
Mailing address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-4961
(703) 792-5699
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202000607
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004978277
—
VA
01
—
187839
BLUE CROSS BLUE SHIELD
VA
Enumeration date
09/15/2008
Last updated
09/15/2008
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