Individual
PATRICIA SHANAHAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
4931 OLD DOMINION DR, ARLINGTON, VA 22207-2833
(703) 623-1806
(703) 241-1910
Mailing address
4931 OLD DOMINION DR, ARLINGTON, VA 22207-2833
(703) 623-1806
(703) 241-1910
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004319
VA
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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