Jordan Wade McDougal, RBT
Behavior Technician in Fredericksburg, VA. Individual provider (NPI-1).
NPI number1669943536
StatusActive
Last updated in NPPESDec 17, 2018
Details
- NPI
- 1669943536
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jordan Wade McDougal
- Credential
- RBT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 17, 2018
- Last updated
- Dec 17, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
1411 Princess Anne StreetFredericksburg, VA 22401
Phone 540-922-1110
Mailing address
114 Jib DrStafford, VA 22554-5322
Phone 540-699-4922
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 285 Behavior Technician providers in Fredericksburg · All 4,989 providers in Fredericksburg
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