Individual
KRISTA WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5606B VIRGINIA BEACH BLVD STE 103, VIRGINIA BEACH, VA 23462-5680
(804) 750-0539
Mailing address
5606B VIRGINIA BEACH BLVD STE 103, VIRGINIA BEACH, VA 23462-5680
(804) 750-0539
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-67329
DE
106S00000X
Behavior Technician
RBT-15-05694
DE
Other
Enumeration date
08/27/2019
Last updated
07/10/2024
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