Individual
MRS. LAURA TAKACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
21495 RIDGETOP CIR STE 202, STERLING, VA 20166-6512
(571) 449-6281
Mailing address
521 LILAC TER NE, LEESBURG, VA 20176-4045
(716) 949-0915
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202007952
VA
Other
Enumeration date
07/25/2018
Last updated
07/25/2018
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