| Farm Creek | |
|
190 Cherry Hill Dr Apt Suite Stafford VA 22556-3654 | |
| (831) 334-0248 | |
| Not Available |
| Full Name | Farm Creek |
|---|---|
| Speciality | Behavior Analyst |
| Location | 190 Cherry Hill Dr Apt Suite, Stafford, Virginia |
| Authorized Official Name and Position | Melanie Kells (OWNER) |
| Authorized Official Contact | 8313340248 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Farm Creek 190 Cherry Hill Dr Apt Suite Stafford VA 22556-3654 Ph: (831) 334-0248 | Farm Creek 190 Cherry Hill Dr Apt Suite Stafford VA 22556-3654 Ph: (831) 334-0248 |
| NPI Number | 1083335608 |
|---|---|
| Provider Enumeration Date | 09/12/2022 |
| Last Update Date | 09/12/2022 |
| Certification Date | 09/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083335608 | NPI | - | NPPES |
| 1275900383 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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