Individual
HANNAH L WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
13135 LEE JACKSON MEMORIAL HWY STE 305, FAIRFAX, VA 22033-1909
(703) 359-8640
(703) 591-6105
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007391
VA
Other
Enumeration date
08/31/2020
Last updated
04/12/2022
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