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Individual

ANGELA MAIJA-LIISA PENN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11 HOPE RD STE 215, STAFFORD, VA 22554-7287
(540) 225-1020
Mailing address
11415 LONE PINE CT, FREDERICKSBURG, VA 22408-0482
(540) 538-5263

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-119255
VA
106S00000X
Behavior Technician

Other

Enumeration date
04/29/2020
Last updated
03/12/2021
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