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Individual

SONIA J MABOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2812 OLD LEE HWY # 100B-D, FAIRFAX, VA 22031-4315
(571) 279-6849
(571) 281-8697
Mailing address
2812 OLD LEE HWY # 100B-D, FAIRFAX, VA 22031-4315
(571) 279-6849
(571) 281-8697

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005904
VA
363AM0700X
Medical Physician Assistant
0010-01955
NC

Other

Enumeration date
02/28/2007
Last updated
06/13/2020
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