Individual
CHANTELLE LAWANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
505 VALOR CT, SUFFOLK, VA 23434-4892
(757) 287-1709
Mailing address
505 VALOR CT, SUFFOLK, VA 23434
(757) 287-1709
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0734010418
VA
106S00000X
Behavior Technician
Primary
RBT-23-312959
VA
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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