Provider Demographics
NPI:1407354129
Name:GOCI, MARIA FERNANDA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:FERNANDA
Last Name:GOCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 COVINGTON TER NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2468
Mailing Address - Country:US
Mailing Address - Phone:571-482-0083
Mailing Address - Fax:
Practice Address - Street 1:44933 GEORGE WASHINGTON BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6301
Practice Address - Country:US
Practice Address - Phone:571-152-0476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-28
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician