Individual
KARLIE RENAE BEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 OLD MEADOW RD, MC LEAN, VA 22102-4311
(703) 216-8100
(866) 889-1406
Mailing address
311 ELLERY CT, FREDERICKSBURG, VA 22408-2542
(540) 846-5074
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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