| Bolivian Health Services Llc | |
|
11130 Fairfax Blvd Ste 305 Fairfax VA 22030-5035 | |
| (571) 918-9977 | |
| (571) 415-5459 |
| Full Name | Bolivian Health Services Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 11130 Fairfax Blvd Ste 305, Fairfax, Virginia |
| Authorized Official Name and Position | Michelle Alvarez (OWNER, BCBA) |
| Authorized Official Contact | 6507200637 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bolivian Health Services Llc 11130 Fairfax Blvd Ste 305 Fairfax VA 22030-5035 Ph: (571) 918-9977 | Bolivian Health Services Llc 11130 Fairfax Blvd Ste 305 Fairfax VA 22030-5035 Ph: (571) 918-9977 |
| NPI Number | 1376259002 |
|---|---|
| Provider Enumeration Date | 01/26/2023 |
| Last Update Date | 01/26/2023 |
| Certification Date | 01/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376259002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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