Individual
DORIEN WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11240 WAPLES MILL RD STE 101, FAIRFAX, VA 22030-6078
(703) 237-2219
(703) 237-2729
Mailing address
4200 HARDY RIDGE DR, WOODBRIDGE, VA 22192-6642
(703) 595-6203
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/06/2017
Last updated
10/06/2017
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