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Individual

AMANDA DESMARAIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
693 LEESVILLE RD, LYNCHBURG, VA 24502-2828
(540) 342-4048
Mailing address
693 LEESVILLE RD, LYNCHBURG, VA 24502-2828

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
11/11/2019
Last updated
11/11/2019
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