Individual
NAWAL ISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2506 COLGRAVE RD, MIDLOTHIAN, VA 23112-3765
(646) 319-4932
Mailing address
2506 COLGRAVE RD, MIDLOTHIAN, VA 23112-3765
(646) 319-4932
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
20-0050R10
WA
246RP1900X
Phlebotomy Technician
—
—
Other
Enumeration date
05/31/2025
Last updated
05/31/2025
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