Individual
REBECCA ANNE BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
293 INDEPENDENCE BLVD STE 400, VIRGINIA BEACH, VA 23462-5461
(757) 490-3009
Mailing address
823 23RD ST, VIRGINIA BEACH, VA 23451-6310
(757) 450-0383
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133001875
VA
106S00000X
Behavior Technician
RBT-19-93360
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396351193
ABA
VA
Enumeration date
07/23/2019
Last updated
12/15/2022
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