Healthcare Provider Details

I. General information

NPI: 1891608576
Provider Name (Legal Business Name): ALANNAH WILSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9110 RAILROAD DR STE 150A
MANASSAS PARK VA
20111-7008
US

IV. Provider business mailing address

170 MARKET ST APT 121
MANASSAS PARK VA
20111-3228
US

V. Phone/Fax

Practice location:
  • Phone: 571-570-1839
  • Fax:
Mailing address:
  • Phone: 434-907-0998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: