Individual
KASEY LYNN MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11240 WAPLES MILL RD STE 101, FAIRFAX, VA 22030-6078
(804) 572-9184
Mailing address
8333 SILKWOOD CT, MECHANICSVILLE, VA 23116-1894
(804) 572-9184
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/04/2019
Last updated
04/04/2019
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