Organization
KID KONCEPTS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTINE M WALLIN RN (DEVELOPMENTAL CONSULTANT)
(703) 346-7243
Entity
Organization
Contact information
Practice address
2861 S F T VALLEY RD, ETLAN, VA 22719-2000
(703) 346-7243
Mailing address
2861 S F T VALLEY RD, ETLAN, VA 22719-2000
(703) 346-7243
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
0001092526
VA
Other
Enumeration date
09/20/2013
Last updated
09/20/2013
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