Individual
MS. HALEY MAI-TRAM LUU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 EDWARDS FERRY RD NE, LEESBURG, VA 20176-3355
(540) 313-0822
Mailing address
44831 MILESTONE SQ APT 336, ASHBURN, VA 20147-4225
(540) 313-0822
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
0230030285
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230030285
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
Enumeration date
09/25/2020
Last updated
09/28/2020
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