Individual
MS. SALLY B. MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC/SP
Contact information
Practice address
7143 SHREVE RD, ACHIEVE BEYOND, FALLS CHURCH, VA 22043
(703) 237-2219
Mailing address
7420 SPRING SUMMIT RD, SPRINGFIELD, VA 22150-4604
(703) 455-5611
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202002028
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
235Z00000X
—
VA
Enumeration date
04/04/2012
Last updated
04/04/2012
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