Individual
BREA BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4161 NEWSOME DR, NEWPORT NEWS, VA 23607-2314
(757) 927-8911
Mailing address
1 MADRONE PL, HAMPTON, VA 23666-6816
(757) 927-8911
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/29/2023
Last updated
07/02/2023
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