Individual
GENESIS ISLENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8405 RICHMOND HWY, ALEXANDRIA, VA 22309-2425
(703) 896-0760
Mailing address
4708 LEHIGH CT, WOODBRIDGE, VA 22193-4635
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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