Individual
CHANELLE DOCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, BCBA, LBA, RDT
Contact information
Practice address
4652 HAYGOOD RD STE C, VIRGINIA BEACH, VA 23455-5447
(757) 655-7274
(775) 392-1245
Mailing address
1219 SKYLARK DR, WESTON, FL 33327-2380
(757) 665-7274
(775) 392-1245
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133001736
VA
221700000X
Art Therapist
—
—
Other
Enumeration date
02/27/2017
Last updated
02/22/2021
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