Organization
WINGS TO FLY THERAPY AND PLAY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA SHANK M.A. (OWNER/DIRECTOR)
(703) 466-5533
Entity
Organization
Contact information
Practice address
4530 WALNEY ROAD, SUITE 203, CHANTILLY, VA 20151
(703) 466-5533
(703) 466-5533
Mailing address
4530 WALNEY ROAD, SUITE 203, CHANTILLY, VA 20151
(703) 466-5533
(703) 466-5533
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
VA
225XP0200X
Pediatric Occupational Therapist
—
VA
235Z00000X
Speech-Language Pathologist
—
VA
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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