Individual
HEIDI SULLIVAN-INYAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14101 GABRIELLE WAY, CENTREVILLE, VA 20121-2418
(703) 895-5529
Mailing address
14101 GABRIELLE WAY, CENTREVILLE, VA 20121-2418
(703) 895-5529
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT23264206
VA
Other
Enumeration date
03/20/2023
Last updated
03/22/2023
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