Individual
BLAIR KATHERINE SIMONETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1831 WIEHLE AVE, RESTON, VA 20190
(703) 709-1114
(703) 709-1117
Mailing address
11800 SUNRISE VALLEY DR STE 800, RESTON, VA 20191-5320
(703) 709-1114
(703) 709-1117
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003695
VA
Other
Enumeration date
10/13/2011
Last updated
07/26/2018
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