Individual
ICEL MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5415 BACKLICK RD, SPRINGFIELD, VA 22151-3915
(703) 941-1910
Mailing address
14752 ENDSLEY TURN, WOODBRIDGE, VA 22193-2751
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/10/2023
Last updated
07/10/2023
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