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General NPI Number Information
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NPI Number | 1316450620
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Entity Type | Individual
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Provider Name | ELIZABETH ROSE VANCE MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 8270 WILLOW OAKS CORPORATE DR
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City | FAIRFAX
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State | VA
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Zip | 22031-4530
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Country | US
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Telephone | 703-916-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 7231 TYLER AVE
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City | FALLS CHURCH
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State | VA
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Zip | 22042-1631
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Country | US
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Telephone | 631-327-5619
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2202007473
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License Number State | VA
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