Individual
MISS GINA MARIE PORCELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9833 PATRIOT HWY, FREDERICKSBURG, VA 22407-9422
(540) 847-1936
Mailing address
10520 ABBERLY VILLAGE LN APT 123, FREDERICKSBURG, VA 22407-2728
(540) 604-7528
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133003729
VA
106S00000X
Behavior Technician
—
VA
Other
Enumeration date
07/02/2019
Last updated
09/13/2024
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