Individual
JACKLYN LE NGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1500 CORNERSIDE BLVD STE B, VIENNA, VA 22182-2437
(571) 623-3307
(571) 623-3307
Mailing address
13704 ASTILBE CT, CENTREVILLE, VA 20120-2601
(703) 593-7797
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202205913
VA
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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