Healthcare Provider Details

I. General information

NPI: 1235975228
Provider Name (Legal Business Name): AMARI PINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8130 MCCAULEY WAY
LORTON VA
22079-2973
US

IV. Provider business mailing address

8130 MCCAULEY WAY APT 1205
LORTON VA
22079-2995
US

V. Phone/Fax

Practice location:
  • Phone: 703-646-8898
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2204001395
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: