Individual
CLAUDIA BOLANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
46040 CENTER OAK PLZ STE 150, STERLING, VA 20166-6611
(703) 997-9494
Mailing address
9503 PAMLICO LN, GREAT FALLS, VA 22066-3807
(703) 203-0568
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
B62481262
VA
Other
Enumeration date
06/28/2019
Last updated
06/28/2019
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