Individual
JENNA RANDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
6328 BUCKNELL CIR, VIRGINIA BEACH, VA 23464-4420
(757) 450-8507
Mailing address
6328 BUCKNELL CIR, VIRGINIA BEACH, VA 23464-4420
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-286012
VA
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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