Individual
SHANNON MARIE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC/SLP
Contact information
Practice address
19465 DEERFIELD AVENUE, SUITE 201, LANSDOWNE, VA 20176
(703) 858-7620
Mailing address
249 SAPPHIRE COURT, WARRENTON, VA 20182
(540) 905-8037
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005359
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008101021
—
VA
Enumeration date
02/15/2008
Last updated
05/07/2008
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