Individual
KHESROW HOTAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
32 REGIS CIR, STERLING, VA 20164-1374
(571) 337-0794
Mailing address
32 REGIS CIR, STERLING, VA 20164-1374
(571) 337-0794
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-161331
VA
Other
Enumeration date
09/02/2021
Last updated
09/02/2021
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