Individual
JESSICA DEAKYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5163 CLEVELAND ST, VIRGINIA BEACH, VA 23462-6501
(757) 645-6509
Mailing address
5163 CLEVELAND ST, VIRGINIA BEACH, VA 23462-6501
(757) 645-6509
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/12/2019
Last updated
09/12/2019
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