Individual
MS. LYDIA DANIELE HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10340 DEMOCRACY LN STE 102B&103, FAIRFAX, VA 22030-2518
(571) 386-3419
Mailing address
87 E GRANDVIEW AVE, CULPEPER, VA 22701-1562
(540) 710-4345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
06/01/2018
Last updated
06/01/2018
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