Individual
MS. COREY SHANICE GWYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5800 QUANTRELL AVE APT 912, ALEXANDRIA, VA 22312-2787
(336) 567-5744
Mailing address
5800 QUANTRELL AVE APT 912, ALEXANDRIA, VA 22312-2787
(336) 567-5744
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP001371
DC
Other
Enumeration date
08/18/2020
Last updated
08/18/2020
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