Individual
EBONY MOEDE-LINDSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11200 WAPLES MILL RD STE 100, FAIRFAX, VA 22030-7475
(703) 237-2219
Mailing address
3887 FAIRFAX RIDGE RD, APT 214, FAIRFAX, VA 22030-7502
(818) 451-8830
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/25/2017
Last updated
11/05/2019
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