Individual
AGNES EMMA KOROMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11308 DOCKSIDE CIR, RESTON, VA 20191-4003
(571) 992-6251
Mailing address
11308 DOCKSIDE CIR, RESTON, VA 20191-4003
(571) 992-6251
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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