Provider Demographics
NPI:1073903795
Name:FOON, DIONE
Entity Type:Individual
Prefix:
First Name:DIONE
Middle Name:
Last Name:FOON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIONE
Other - Middle Name:
Other - Last Name:TANPATANACHAREON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45130 COLUMBIA PL
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-2500
Mailing Address - Country:US
Mailing Address - Phone:703-463-2009
Mailing Address - Fax:
Practice Address - Street 1:45130 COLUMBIA PL
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-2500
Practice Address - Country:US
Practice Address - Phone:703-463-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0203015089390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program