Individual
CHRISTIANA N/A TWENBOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10379B DEMOCRACY LN, FAIRFAX, VA 22030-2505
(703) 679-7856
Mailing address
10379B DEMOCRACY LN, FAIRFAX, VA 22030-2505
(703) 679-7856
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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