Individual
MICHAEL MAHONEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
13890 BRADDOCK RD, STE. 207, CENTREVILLE, VA 20121-2435
(540) 720-2261
(540) 720-5660
Mailing address
45410 MALLARD ST, STERLING, VA 20165-2527
(703) 955-6983
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202007902
VA
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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