Individual
MADELINE LILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
CENTRAL OFFICE ADDRESS, 100 PARK CENTRAL PLAZA SUITE 300, MANASSAS, VA 20111
(703) 392-1317
Mailing address
CENTRAL OFFICE ADDRESS, 100 PARK CENTRAL PLAZA SUITE 300, MANASSAS, VA 20111
(703) 392-1317
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010486
VA
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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