Individual
MRS. CHENELLE DM HAYGOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 OLD MEADOW RD STE 600, MC LEAN, VA 22102-4389
(800) 828-5659
Mailing address
43500 JUBILEE ST, CHANTILLY, VA 20152-1734
(973) 641-0344
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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