Individual
MS. LORI ANN FADELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1411 ZION CHURCH RD, MAURERTOWN, VA 22644
(540) 533-9651
Mailing address
1411 ZION CHURCH RD, MAURERTOWN, VA 22644
(540) 533-9651
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
CP-391602
VA
252Y00000X
Early Intervention Provider Agency
Primary
CP-391602
VA
Other
Enumeration date
06/18/2010
Last updated
12/02/2024
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