Individual
SILLA HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9606 GLENARM CT, BURKE, VA 22015-1721
(347) 255-5951
Mailing address
9606 GLENARM CT, BURKE, VA 22015-1721
(347) 255-5951
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
PGP-0653604
VA
Other
Enumeration date
01/30/2013
Last updated
01/30/2013
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