Individual
HOMEIRA FALLAHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
602 PLUM ST SW, VIENNA, VA 22180-6328
(571) 635-9349
Mailing address
602 PLUM ST SW, VIENNA, VA 22180-6328
(571) 635-9349
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22246121
VA
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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