Organization
NORTHERN VIRGINIA AUTISM THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARA MARZ SIDDIQUI (OWNER)
(571) 409-8841
Entity
Organization
Contact information
Practice address
8300 BOONE BLVD STE 500, VIENNA, VA 22182-2681
(571) 409-8841
Mailing address
3399 BOUNTIFUL LN, WOODBRIDGE, VA 22193-5538
(571) 409-8841
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/30/2025
Last updated
07/30/2025
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