Individual
JOHNNA STOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
2616 SHERWOOD HALL LN STE 408, ALEXANDRIA, VA 22306-3154
(703) 780-8929
(703) 921-1056
Mailing address
6355 WALKER LN STE 411, ALEXANDRIA, VA 22310-3250
(703) 922-4262
(703) 921-1056
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201001884
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15593720
CAQH
—
01
—
2201001884
VIRGINIA LICENSE
VA
Enumeration date
07/18/2022
Last updated
07/18/2022
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