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Individual

LIANNA BODINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CCC-SLP

Contact information

Practice address
4560 SOUTH BLVD, SUITE 310, VIRGINIA BEACH, VA 23452-1160
(757) 490-3223
(757) 490-2936
Mailing address
4560 SOUTH BLVD, SUITE 310, VIRGINIA BEACH, VA 23452-1160
(757) 490-3223
(757) 490-2936

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202007186
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2202007186
STATE LICENSE
VA
Enumeration date
06/18/2014
Last updated
06/18/2014
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