Individual
MRS. JENNA SINGH BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, RBT
Contact information
Practice address
1651 OLD MEADOW RD STE 600, MC LEAN, VA 22102-4389
(703) 506-0123
Mailing address
621 COBBLESTONE BLVD UNIT 106, FREDERICKSBURG, VA 22401-6608
(540) 907-9406
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB404256
VA
Other
Enumeration date
01/28/2018
Last updated
01/28/2018
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