Individual
LEAH JOY MADDOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9963 MALLOW ST, MANASSAS, VA 20110-4218
(323) 313-7659
(703) 257-7609
Mailing address
9963 MALLOW ST, MANASSAS, VA 20110-4218
(323) 313-7659
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
VA
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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