Individual
TIMOTHY HENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
188 OVILLE RD, STAFFORD, VA 22556
(540) 645-4777
Mailing address
507 SANTEE DR, SPOTSYLVANIA, VA 22551-2812
(540) 505-1394
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT-24-395251
—
Other
Enumeration date
11/29/2024
Last updated
11/29/2024
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