Individual
AVERY BRAND JAKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
14428 ALBEMARLE POINT PL STE 150B, CHANTILLY, VA 20151-1752
(240) 342-2666
Mailing address
14428 ALBEMARLE POINT PL STE 150B, CHANTILLY, VA 20151-1752
(240) 342-2666
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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