Individual
AALIYAH HAISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LPN
Contact information
Practice address
102 EXCALIBER CIR, 104, FREDERICKSBURG, VA 22406-6482
(540) 661-9007
(703) 890-2969
Mailing address
102 EXCALIBER CIR, 104, FREDERICKSBURG, VA 22406-6482
(540) 661-9007
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
S4493401
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0172986405
—
VA
Enumeration date
10/23/2014
Last updated
10/23/2014
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