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1003525072
DOMONIQUE RICHARDSON
FAIRFAX, VA
NPI
1003525072
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2022-11-18
Last Update Date
2024-11-18
Business Address
DOMONIQUE RICHARDSON
10340 DEMOCRACY LN STE BAND103
FAIRFAX, VA 22030-2518
Phone number: 571-386-0871
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Mailing Address
DOMONIQUE RICHARDSON
5850 GRANITE PKWY STE 600
PLANO, TX 75024-6753
Phone number:
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