Search › Virginia › 101YP2500X

Carly Ikuma

NPI 1427571629 · on the registry since 2017

Practice

Address
9663 Main St Ste D
Fairfax, VA 22031
Phone
(703) 303-8832
Organisation at this address
Vanguard Therapy, Llc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
101YP2500X
101YP2500X
Licence states on file
VA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2017-08-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia