Individual
MARY MATTARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7001A LOISDALE RD, SPRINGFIELD, VA 22150-1904
(703) 791-0602
Mailing address
7001A LOISDALE RD, SPRINGFIELD, VA 22150-1904
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202007136
VA
Other
Enumeration date
02/03/2014
Last updated
02/03/2014
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