Individual
JANNA PATRICIA DIAMSE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
5045 MADEIRA RD, VIRGINIA BEACH, VA 23455-3956
(757) 339-4198
(757) 561-2627
Mailing address
5045 MADEIRA RD, VIRGINIA BEACH, VA 23455-3956
(757) 339-4198
(757) 561-2627
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-133430
VA
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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