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Individual

DEIDRE EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
13137 THRIFT LN, WOODBRIDGE, VA 22193-6102
(571) 343-9182
Mailing address
13137 THRIFT LN, WOODBRIDGE, VA 22193-6102

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12043089
FL
103K00000X
Behavior Analyst
106S00000X
Behavior Technician
RBT-18-49396
FL

Other

Enumeration date
02/15/2018
Last updated
12/21/2023
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