Individual
MICHELLE RAINVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12191 CLIPPER DR, LAKE RIDGE, VA 22192-2237
(703) 496-3400
Mailing address
12191 CLIPPER DR, LAKE RIDGE, VA 22192-2237
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
01454L
MD
235Z00000X
Speech-Language Pathologist
Primary
2202008907
VA
Other
Enumeration date
05/31/2017
Last updated
03/02/2019
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