Individual
LARISA AYN MANZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
3855 CENTERVIEW DR STE 400B, CHANTILLY, VA 20151-3285
(854) 844-1116
Mailing address
1500 DOUGLAS RD, SUITE 230, CORAL GABLES, FL 33134-7807
(854) 844-1116
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133001741
VA
Other
Enumeration date
01/21/2019
Last updated
03/19/2024
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