Individual
MICKIAS AMANUEL TESFAMARIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1968 EDNA WAY, VIRGINIA BEACH, VA 23464-1794
(757) 556-8708
Mailing address
1968 EDNA WAY, VIRGINIA BEACH, VA 23464-1794
(757) 556-8708
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/12/2022
Last updated
08/12/2022
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