Individual
AMINA BLACKSON
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
9667 PEP RALLY LN, WALDORF, MD 20603-5360
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
11/20/2025
Last updated
11/20/2025
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