Individual
MARY B CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3600 JOSEPH SIEWICK DR, FAIRFAX, VA 22033-1709
(703) 391-3129
(703) 391-4271
Mailing address
1641 MONTMORENCY DR, VIENNA, VA 22182-2022
(703) 938-8090
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00010494287
VA
Other
Enumeration date
06/03/2006
Last updated
07/08/2007
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