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Individual

HUNTER PHELAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
293 INDEPENDENCE BLVD STE 400, VIRGINIA BEACH, VA 23462-5461
(757) 490-3009
Mailing address
807 FOXMOORE CT, VIRGINIA BEACH, VA 23462-5265
(504) 444-2609

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-260070
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106S00000X
VA
Enumeration date
02/24/2023
Last updated
02/24/2023
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