Individual
MISS BAABA SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13662 OFFICE PL STE 104, WOODBRIDGE, VA 22192-4217
(703) 910-7257
Mailing address
13662 OFFICE PL STE 104, WOODBRIDGE, VA 22192-4217
(703) 910-7257
(703) 910-7093
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
11/23/2012
Last updated
05/18/2024
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