Individual
EMILY JANE BANKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6216 OLD KEENE MILL CT, SPRINGFIELD, VA 22152-2323
(571) 297-4308
Mailing address
4424 CORTEZ DR, FAIRFAX, VA 22030-5308
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-223083
VA
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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