Individual
KATHY M WALDREP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2186 OLD PIPERS GAP RD, CANA, VA 24317-4117
(561) 315-3698
Mailing address
2186 OLD PIPERS GAP RD, CANA, VA 24317-4117
(561) 315-3698
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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