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Individual

RYAN LEE MASTROPAOLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPTA

Contact information

Practice address
2806 LEE OAKS PL, APT 101, FALLS CHURCH, VA 22046-7345
(207) 232-4619
Mailing address
2806 LEE OAKS PL, APT 101, FALLS CHURCH, VA 22046-7345
(207) 232-4619

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
RBT-16-17379
VA
225200000X
Physical Therapy Assistant
Primary
2306603629
VA

Other

Enumeration date
08/23/2016
Last updated
09/02/2016
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