Individual
SEYEDEH MARYAM MADANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2404 EARLSGATE CT, RESTON, VA 20191-1608
(202) 769-8689
Mailing address
2404 EARLSGATE CT, RESTON, VA 20191-1608
(202) 769-8689
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001265636
VA
174N00000X
Lactation Consultant (Non-RN)
Primary
311-78094
ZZ
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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