Individual
JASMINE SOFIA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3344 LOCKHEED BLVD APT 1, ALEXANDRIA, VA 22306-2031
(703) 618-1047
Mailing address
3344 LOCKHEED BLVD APT 1, ALEXANDRIA, VA 22306-2031
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/28/2021
Last updated
08/28/2021
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