Healthcare Provider Details

I. General information

NPI: 1114187358
Provider Name (Legal Business Name): MARGIE COMERFORD SLP, CCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2008
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44035 RIVERSIDE PKWY SUIE 500A
LEESBURG VA
20176-8260
US

IV. Provider business mailing address

9900 MAIN ST SUITE 200A
FAIRFAX VA
22031-3907
US

V. Phone/Fax

Practice location:
  • Phone: 703-858-6667
  • Fax: 703-858-6665
Mailing address:
  • Phone: 703-279-4249
  • Fax: 703-279-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30001321
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: