Individual
HAYAT TICKUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4400 UNIVERSITY DR, FAIRFAX, VA 22030-4422
(292) 756-1245
Mailing address
5822 WESTCHESTER ST, ALEXANDRIA, VA 22310-1121
(202) 746-1245
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/24/2022
Last updated
02/28/2022
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