Individual
JACQUELINE RENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
14715 BRISTOW RD, MANASSAS, VA 20112-3945
(571) 455-4639
Mailing address
10831 PAYNES CHURCH DR, FAIRFAX, VA 22032-2918
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2203000147
VA
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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