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Individual

AMANDA BREADY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
23420 SUMMERSTOWN PL, DULLES, VA 20166-2178
(703) 606-3806
Mailing address
23420 SUMMERSTOWN PL, DULLES, VA 20166-2178
(703) 606-3806

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
0019017046
VA
251E00000X
Home Health Agency
Primary
HCO-233043
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30017487950001
VA
Enumeration date
12/27/2019
Last updated
01/30/2023
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