Individual
JENESIS ALIYAH PRIESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11200 WAPLES MILL RD STE 100, FAIRFAX, VA 22030-7475
(703) 237-2219
Mailing address
225 BROADHOLLOW RD, MELVILLE, NY 11747-4822
(631) 385-7780
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/24/2022
Last updated
03/24/2022
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