Individual
ASTRID WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12111 POLO DR APT 122, FAIRFAX, VA 22033-4026
(512) 897-5564
Mailing address
12111 POLO DR APT 122, FAIRFAX, VA 22033-4026
(512) 897-5564
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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