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General NPI Number Information
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NPI Number | 1144191594
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Entity Type | Organization
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Legal Business Name | CAPITAL DYSPHAGIA DIAGNOSTICS LLC
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 3903 FAIR RIDGE DR STE L
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City | FAIRFAX
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State | VA
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Zip | 22033-2943
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Country | US
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Telephone | 703-239-4560
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Fax |
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Provider Business Mailing Address
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Address Line | 3903 FAIR RIDGE DR SUITE L #310
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City | FAIRFAX
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State | VA
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Zip | 22033
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Country | US
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Telephone | 703-239-4560
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST/OWNER
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Name | CAITLYN LEE
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Credential | SLP
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Telephone | 703-239-4560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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