Individual
LAUREN MARIE GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12124 FORT CRAIG DR, WOODBRIDGE, VA 22192-1012
(571) 335-6185
Mailing address
12124 FORT CRAIG DRIVE, WOODBRIDGE, VA 22192
(571) 335-6185
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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