Individual
ALFREDA MAYENI VANDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
4528 PLANK RD STE A3, FREDERICKSBURG, VA 22407-0141
(571) 277-0440
Mailing address
4528 PLANK RD STE A3, FREDERICKSBURG, VA 22407-0141
(571) 277-0440
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104179159
—
VA
Enumeration date
03/11/2022
Last updated
03/11/2022
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