Individual
SAMANTHA THEVERAPPERUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
5621 TIDEWATER DR, NORFOLK, VA 23509-1497
(757) 351-4244
Mailing address
5621 TIDEWATER DR, NORFOLK, VA 23509-1497
(757) 351-4244
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
05/09/2019
Last updated
01/19/2024
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