Dominion Aba
NPI #1134594864 in Colonial Heights, Virginia
Provider Information
- NPI Number
- 1134594864
- Entity Type
- Organization
- Organization Name
- Dominion Aba
- Primary Specialty
- Early Intervention Provider Agency
- Enumeration Date
- Dec 7, 2015
- Last Updated
- Dec 7, 2015
Practice Location
- Address
- 2903 BOULEAVARD
- City
- Colonial Heights
- State
- Virginia
- ZIP Code
- 23834
- Phone
- (804) 484-4719
Authorized Official
- Name
- MR. MATTHEW DOUGLAS WYNN, LABA
- Title
- ASSISTANT BEHAVIOR ANALYST
- Phone
- (804) 484-4719
Specialties & Taxonomy Codes
| Specialty |
|---|
| Early Intervention Provider Agency |
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