Healthcare Provider Details

I. General information

NPI: 1639052707
Provider Name (Legal Business Name): CAROLINA ZAPATA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14428 ALBEMARLE POINT PL STE 150B
CHANTILLY VA
20151-1752
US

IV. Provider business mailing address

14428 ALBEMARLE POINT PL STE 150B
CHANTILLY VA
20151-1752
US

V. Phone/Fax

Practice location:
  • Phone: 703-712-7622
  • Fax:
Mailing address:
  • Phone: 703-712-7622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: