Individual
JAYLA MARIE ETIENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
103 RESEARCH DR, HAMPTON, VA 23666-1340
(757) 788-8490
Mailing address
103 RESEARCH DR, HAMPTON, VA 23666-1340
(757) 788-8490
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-299249
VA
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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