Individual
LIZANE VAN STADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2721 PROSPERITY AVE STE 100, FAIRFAX, VA 22031-4341
(240) 342-2666
Mailing address
2721 PROSPERITY AVE STE 100, FAIRFAX, VA 22031-4341
(240) 342-2666
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/06/2026
Last updated
05/06/2026
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