Individual
LISIANE POOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11240 WAPLES MILL RD STE 101, FAIRFAX, VA 22030-6078
(571) 639-9276
Mailing address
11200 WAPLES MILL RD STE 202, FAIRFAX, VA 22030-7407
(571) 639-9276
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/16/2018
Last updated
09/27/2021
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