Individual
COLIN HERNDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1640 BORO PL FL 4, MC LEAN, VA 22102-3627
(571) 888-2942
Mailing address
1640 BORO PL FL 4, MC LEAN, VA 22102-3627
(571) 888-2942
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23284845
VA
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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