Individual
JESSICA PATRICIA OSTORGA AMAYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10565 FAIRFAX BLVD, FAIRFAX, VA 22030-3135
(703) 218-6599
Mailing address
10105 MAKELYS WAY, MANASSAS, VA 20110-6063
(703) 586-2214
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-284768
VA
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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