NPI 1003525072

Domonique Richardson

Practitioner Case Manager/Care Coordinator Fairfax, VA

Practice location

Address: 10340 Democracy Ln STE Band103, Fairfax, VA 22030-2518
Phone: (571) 386-0871
Mailing address: 5850 Granite Pkwy STE 600, Plano, TX 75024-6753

Registered specialties (2)

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X

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Behavior Technician

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Registry record

NPI: 1003525072
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Nov 2022
Record last updated: 18 Nov 2024

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.