Individual
MISS AUTUMN FAITH RAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
729 SHELL RD, CHESAPEAKE, VA 23323-3236
(757) 803-7727
Mailing address
729 SHELL RD, CHESAPEAKE, VA 23323-3236
(757) 803-7727
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
VA
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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