Provider Demographics
NPI:1881851624
Name:DART, ADELA MITCHELL (SLP)
Entity type:Individual
Prefix:MRS
First Name:ADELA
Middle Name:MITCHELL
Last Name:DART
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MISS
Other - First Name:ADELA
Other - Middle Name:CLAUDIA
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2673 JETSTREAM RD
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2499
Mailing Address - Country:US
Mailing Address - Phone:757-513-4808
Mailing Address - Fax:
Practice Address - Street 1:2673 JETSTREAM RD
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2499
Practice Address - Country:US
Practice Address - Phone:757-513-4808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004073235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist