Individual
KATHLEEN MAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5500 TRAMORE CT, FAIRFAX, VA 22032-3126
(703) 409-9693
Mailing address
5500 TRAMORE CT, FAIRFAX, VA 22032-3126
(703) 409-9693
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1500605
VA
Other
Enumeration date
05/19/2017
Last updated
07/21/2022
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