NPI 1134594864
Dominion Aba
Practice location
- Address
- 2903 Bouleavard, Colonial Heights, VA 23834
- Phone
- (804) 484-4719
- Mailing address
- 2903 Boulevard, Colonial Heights, VA 23834-2401
Authorised official
- Name
- Matthew Douglas Wynn
- Title
- Assistant Behavior Analyst
- Phone
- (804) 484-4719
Registered specialties
Early Intervention Provider Agency
Primary
Registry record
- NPI
- 1134594864
- Entity type
- Organization
- NPI issued
- 7 Dec 2015
- Record last updated
- 7 Dec 2015
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.