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Individual

BETHANY JAYNE GINGELL CONCEPCION

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11 HOPE RD, STAFFORD, VA 22554-7287
(813) 244-0582
Mailing address
208 GETTYSBURG CT, STAFFORD, VA 22554-8473
(571) 263-9828

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
11/18/2020
Last updated
11/18/2020
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