Individual
DEMITRIA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14059 CROWN CT, WOODBRIDGE, VA 22193-1458
(571) 368-6876
(877) 734-1914
Mailing address
2 VILLAGE SQUARE SUITE 210, BALTIMORE, MD 21210-1624
(866) 565-7222
(877) 734-1914
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-338114
VA
Other
Enumeration date
07/17/2023
Last updated
05/23/2024
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