Individual
JESSICA LYNN BALDUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 CONFROY DR STE 4, SOUTH BOSTON, VA 24592-7163
(434) 797-5531
Mailing address
1100 CONFROY DR STE 4, SOUTH BOSTON, VA 24592-7163
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-280781
VA
Other
Enumeration date
09/26/2023
Last updated
09/27/2023
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