Individual
BRYNDIE MARISE BALLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45305 CATALINA CT BLDG B, STERLING, VA 20166-2369
(571) 441-3177
Mailing address
4501 GASTON ST, CHANTILLY, VA 20151-2244
(202) 760-1433
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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