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General NPI Number Information
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NPI Number | 1578042073
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Entity Type | Organization
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Legal Business Name | POTOMAC SPEECH, LLC
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 08/07/2018
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Provider Practice Location Address
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Address Line | 20657 SHOAL PLACE
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City | STERLING
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State | VA
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Zip | 20165
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Country | US
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Telephone | 301-908-0099
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Fax |
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Provider Business Mailing Address
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Address Line | 673 POTOMAC STATION DR NE # 124
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City | LEESBURG
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State | VA
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Zip | 20176-1819
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Country | US
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Telephone | 301-908-0099
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | MS. LINDSAY MILLER
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Credential | M.A., CCC-SLP
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Telephone | 301-908-0099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State | VA
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