Individual
ANNE BONAFEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 OLD MEADOW RD STE 600, MC LEAN, VA 22102-4389
(703) 564-1662
Mailing address
12602 BAYOU DR, HERNDON, VA 20170-2918
(571) 482-0836
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/07/2020
Last updated
01/07/2020
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