Individual
HALA D MATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3053 NUTLEY ST, FAIRFAX, VA 22031-1931
(703) 615-8664
(914) 206-1568
Mailing address
16024 BARN SWALLOW PL, WOODBRIDGE, VA 22191-5542
(703) 615-8664
(914) 206-1568
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F06212895
VA
Other
Enumeration date
08/26/2021
Last updated
01/02/2026
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