Holly Dara Thammavongsa

NPI #1689174252 in Sterling, Virginia

Provider Information

NPI Number: 1689174252
Entity Type: Individual
Name: Holly Dara Thammavongsa
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Feb 20, 2018
Last Updated: Feb 20, 2018

Practice Location

Address: 46040 CENTER OAK PLZ STE 150
City: Sterling
State: Virginia
ZIP Code: 20166-6611
Phone: (703) 997-9494

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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