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General NPI Number Information
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NPI Number | 1346975067
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Entity Type | Individual
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Provider Name | JOHNNA STOUP AUD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 2616 SHERWOOD HALL LN STE 408
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City | ALEXANDRIA
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State | VA
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Zip | 22306-3154
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Country | US
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Telephone | 703-780-8929
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Fax | 703-921-1056
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Provider Business Mailing Address
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Address Line | 6355 WALKER LN STE 411
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City | ALEXANDRIA
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State | VA
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Zip | 22310-3250
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Country | US
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Telephone | 703-922-4262
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Fax | 703-921-1056
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 2201001884
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License Number State | VA
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