Provider Demographics
NPI:1477796878
Name:SYRON, CAROLYN JEAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JEAN
Last Name:SYRON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7617 LITTLE RIVER TPKE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2603
Mailing Address - Country:US
Mailing Address - Phone:703-941-7757
Mailing Address - Fax:
Practice Address - Street 1:7617 LITTLE RIVER TPKE
Practice Address - Street 2:SUITE 310
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2603
Practice Address - Country:US
Practice Address - Phone:703-941-7757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202003585235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist