Individual
MADISON SALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
804 MOOREFIELD PARK DR STE 101, NORTH CHESTERFIELD, VA 23236-3670
(800) 557-6330
Mailing address
1000 PARK FORTY PLZ STE 110, DURHAM, NC 27713-5249
(800) 557-6330
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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