Individual
SU JI PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8230 LEESBURG PIKE STE 740, VIENNA, VA 22182-2641
(877) 504-4141
Mailing address
24602 SILTSTONE SQ, ALDIE, VA 20105-3001
(540) 622-7415
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-64525
VA
Other
Enumeration date
03/07/2023
Last updated
03/30/2023
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