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Individual

BAILEE NICOLE DENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11 HOPE RD STE 215, STAFFORD, VA 22554-7287
(866) 311-4617
Mailing address
401 COBBLESTONE DR APT 208, FREDERICKSBURG, VA 22401-6664
(434) 430-0616

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1306202940
TRICARE
VA
Enumeration date
02/11/2020
Last updated
11/27/2023
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