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1669943536
JORDAN WADE MCDOUGAL
FREDERICKSBURG, VA
NPI
1669943536
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-12-17
Last Update Date
2018-12-17
Business Address
Mr. JORDAN WADE MCDOUGAL RBT
1411 PRINCESS ANNE STREET
FREDERICKSBURG, VA 22401
Phone number: 540-922-1110
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Mailing Address
Mr. JORDAN WADE MCDOUGAL RBT
114 JIB DR
STAFFORD, VA 22554-5322
Phone number: 540-699-4922
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