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Individual

FRIBA WASIQ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7857 ENOLA ST APT TA7, MC LEAN, VA 22102-7836
(571) 426-2509
Mailing address
5205 HEMING AVE, SPRINGFIELD, VA 22151-2936
(571) 426-2509

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002087645
VA

Other

Enumeration date
07/13/2021
Last updated
07/13/2021
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