Individual
SUMMER MORIAH RUTH PETRILLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
10530 WARWICK AVE STE C2, FAIRFAX, VA 22030-3132
(703) 731-4766
Mailing address
5 RUTLEDGE CT, STERLING, VA 20165-6243
(703) 731-4766
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1-06-3131
VA
Other
Enumeration date
05/26/2008
Last updated
01/14/2022
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