Individual
LORENTE CHANCE BLAKENEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3630 GEORGE WASHINGTON MEM HWY STE D, YORKTOWN, VA 23693-3350
(757) 586-5252
Mailing address
3630 GEORGE WASHINGTON MEM HWY STE D, YORKTOWN, VA 23693-3350
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-371029
VA
Other
Enumeration date
08/29/2024
Last updated
08/29/2024
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