Individual
JENNIFER PEARSON DE LA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 WASHINGTON BLVD, ARLINGTON, VA 22201-4508
(703) 351-9220
(844) 411-6504
Mailing address
2114 FREDA DR, VIENNA, VA 22181-3259
(703) 517-7167
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202011800
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0202011800
PHARMACY LICENSE
VA
01
—
VIRGINIA
0202011800
—
Enumeration date
11/14/2020
Last updated
11/14/2020
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