Individual
MRS. CORNELIA HAWKINS LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2544 PORT POTOMAC AVE, WOODBRIDGE, VA 22191-1464
(703) 409-1822
(703) 670-8923
Mailing address
2544 PORT POTOMAC AVE, WOODBRIDGE, VA 22191-1464
(703) 409-1822
(703) 670-8923
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004350
VA
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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