Medeiros, Nicolle Adele

Medeiros, Nicolle Adele is an individual health care provider with primary practice located at 11240 Waples Mill Rd Suite 101, Fairfax VA 22030-6078. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavior Technician is her primary health care specialty. Medeiros, Nicolle Adele can be contacted via phone (703) 237-2219.

Contact Information

Primary practice address
11240 Waples Mill Rd Suite 101 Fairfax VA 22030-6078
Phone: (703) 237-2219
Fax: (703) 237-2729
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X

Profile Details

NPI number 1225442817
LBN Legal business name Medeiros, Nicolle Adele
Credentials B.S.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2014
Last updated Jan 5th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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