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NPI Code Detail

MEDICARE: WHITNEY MISLOCK CCC-SLP

MEDICARE: WHITNEY MISLOCK CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2202008166VA

General Provider Information

NPI Number : 1891325189
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY MISLOCK CCC-SLP
Provider Business Mailing Address
First Line : 1511 STUART RD
Second Line :
City : RESTON
State : VA
Zip : 20194-2710
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19465 DEERFIELD AVE STE 201
Second Line :
City : LANSDOWNE
State : VA
Zip : 20176-1703
Country : US
Telephone Number : 703-858-7620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2020
Last Update Date : 01/25/2020

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Directions to “ WHITNEY MISLOCK CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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