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1043857667
LARISSA NICOLE KELLY
STAFFORD, VA
NPI
1043857667
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-12-02
Last Update Date
2019-12-02
Business Address
LARISSA NICOLE KELLY
2761 JEFFERSON DAVIS HWY STE 107
STAFFORD, VA 22554-8330
Phone number: 540-699-3877
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Mailing Address
LARISSA NICOLE KELLY
21600 OXNARD ST STE 1800
WOODLAND HILLS, CA 91367-7807
Phone number: 818-345-2345
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