Individual
MR. JORDAN WADE MCDOUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
1411 PRINCESS ANNE STREET, FREDERICKSBURG, VA 22401
(540) 922-1110
Mailing address
114 JIB DR, STAFFORD, VA 22554-5322
(540) 699-4922
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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