Individual
KIANA NIFARETTE PORTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8230 LEESBURG PIKE STE 740, VIENNA, VA 22182-2641
(877) 504-4141
Mailing address
8525 JENNER CT, SPRINGFIELD, VA 22153-3423
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
11/14/2022
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