Individual
TSII CARINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10708 MARLBOROUGH RD, FAIRFAX, VA 22032-2222
(571) 492-8226
Mailing address
10708 MARLBOROUGH RD, FAIRFAX, VA 22032-2222
(571) 492-8226
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
1401193068
VA
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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