Individual
LISA SHORTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
490 EVERGREEN MILL RD SE, LEESBURG, VA 20175-8724
(571) 252-2840
Mailing address
490 EVERGREEN MILL RD SE, LEESBURG, VA 20175-8724
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/02/2018
Last updated
04/02/2018
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