Individual
DEBORAH RICHARDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4207 SAN JUAN DR, FAIRFAX, VA 22030-5375
(703) 855-4293
Mailing address
5204 MORRIS AVE APT 203, SUITLAND, MD 20746-3908
(703) 855-4293
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019016159
VA
Other
Enumeration date
11/13/2019
Last updated
11/13/2019
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