Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1101X | Ophthalmic Assistant |
NPI | 1568854255 |
---|---|
Provider Name | Kristina K Reyes |
First Address | Falls Church, VA 22044-2102 |
Second Address | Falls Church, VA 22044-2102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2015 |
Last Update Date | 04/03/2015 |