Individual
ALICIA DIANE GOOSSENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8202 EUCLID AVE, MANASSAS PARK, VA 20111-2353
(703) 361-1510
Mailing address
8202 EUCLID AVE, MANASSAS PARK, VA 20111-2353
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204000754
VA
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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