Individual
KIMBERLY SELINE MUNGUIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11200 WAPLES MILL RD STE 100, FAIRFAX, VA 22030-7475
(703) 237-2219
Mailing address
3933 PROVIDENCE PL, FAIRFAX, VA 22031-3407
(571) 241-6368
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/07/2022
Last updated
09/07/2022
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