Individual
ETHAN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1464 MOUNT PLEASANT RD, CHESAPEAKE, VA 23322-4043
(757) 632-7221
(888) 681-7221
Mailing address
1464 MOUNT PLEASANT RD, CHESAPEAKE, VA 23322-4043
(757) 632-7221
(888) 681-7221
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-458158
VA
Other
Enumeration date
10/17/2025
Last updated
10/17/2025
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