Individual
MS. IBTIDA YANAT FARUQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9309 CENTER ST, MANASSAS, VA 20110-5599
(443) 690-5857
Mailing address
9309 CENTER ST, MANASSAS, VA 20110-5599
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-254160
—
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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