Individual
ANNA MONINA MENDOZA VANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP CCC
Contact information
Practice address
10501 GREENE DR, LORTON, VA 22079-3540
(571) 289-4742
Mailing address
10501 GREENE DR, LORTON, VA 22079-3540
(571) 289-4742
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010931
VA
235Z00000X
Speech-Language Pathologist
SLP200001549
DC
Other
Enumeration date
02/20/2017
Last updated
02/09/2024
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