Individual
MS. KRISTI LEANN PADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22375 BRODERICK DR, STERLING, VA 20166-9371
(571) 375-0214
Mailing address
22575 LEANNE TER APT 403, ASHBURN, VA 20148-6856
(571) 528-4014
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-171923
VA
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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