Individual
EMILY DETTBARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2710 PROSPERITY AVE, FAIRFAX, VA 22031-4357
(702) 289-1290
Mailing address
4439 ROSENWALD LN, FAIRFAX, VA 22030-5194
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001312433
VA
Other
Enumeration date
02/03/2026
Last updated
02/03/2026
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