Individual
CARLY CORVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 OLD MEADOW RD, MC LEAN, VA 22102-4311
(800) 828-5659
Mailing address
9100 WINFIELD CT, FREDERICKSBURG, VA 22408-1748
(540) 841-0743
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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