Individual
MRS. HEATHER ANNE DECKELBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC
Contact information
Practice address
626 GRANT ST STE K, HERNDON, VA 20170-4700
(703) 904-8334
Mailing address
626 GRANT ST STE K, HERNDON, VA 20170-4700
(703) 904-8334
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005031
VA
Other
Enumeration date
02/26/2007
Last updated
07/19/2007
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