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Individual

LAURA JEAN MANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031
(703) 227-2664
Mailing address
8270 WILLOW OAKS CORPORATE DR STE, FAIRFAX, VA 22031
(703) 227-2664

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
05449
MD
235Z00000X
Speech-Language Pathologist
Primary
2202005101
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2202005101
BOARD OF AUDIOLOGY AND SPEECH LANGUAGE PATHOLOGY
VA
Enumeration date
03/29/2007
Last updated
05/10/2018
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