Organization
AXIOM LINK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIA S. MATUZA (CEO)
(718) 762-7633
Entity
Organization
Contact information
Practice address
11240 WAPLES MILL RD, SUITE 101, FAIRFAX, VA 22030
(703) 237-2219
(703) 237-2729
Mailing address
11240 WAPLES MILL RD, SUITE 101, FAIRFAX, VA 22030
(703) 237-2219
(703) 237-2729
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/13/2011
Last updated
04/09/2015
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