Individual
MISS ALYSSA MARIE FANIZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5415C BACKLICK RD, SPRINGFIELD, VA 22151-3915
(703) 941-1910
Mailing address
5415C BACKLICK RD, SPRINGFIELD, VA 22151-3915
(703) 941-1910
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699097139
—
VA
Enumeration date
02/02/2022
Last updated
02/02/2022
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