Individual
OLIVIA LE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3903 FAIR RIDGE DR STE 209, FAIRFAX, VA 22033-2944
(703) 424-9676
Mailing address
14276 LADDERBACKED DR, GAINESVILLE, VA 20155-5919
Taxonomy
Speciality
Code
Description
License number
State
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
0024182153
VA
363LF0000X
Family Nurse Practitioner
Primary
0024182153
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
N/A
—
01
—
NONE
NONE
—
Enumeration date
12/16/2021
Last updated
04/07/2022
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