Individual
LYAN WARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4225 PORTSMOUTH BLVD STE B, CHESAPEAKE, VA 23321-2154
(757) 292-4774
Mailing address
4225 PORTSMOUTH BLVD STE B, CHESAPEAKE, VA 23321-2154
(757) 292-4774
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-70034
VA
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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