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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

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Active Sole Proprietor

VA Clinic · WOODBRIDGE, VA

Registration Details

NPI Number
1154870145
Provider Type
Individual
Gender
Female
NPI Issued
Oct 1, 2016 (9.5565194228318 yrs)
Last Updated
Oct 1, 2016
License
0202205698 (VA)
Sole Proprietor
Yes

Practice Information

Address
14139 POTOMAC MILLS RD
WOODBRIDGE, VA, 221924644
Browse VA providers · Browse ZIP 22192
Phone
7034908400
Primary Specialty
VA Clinic
261QV0200X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.