Individual
MRS. KIRA MARIE MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
161 GRANBY ST PH 2, NORFOLK, VA 23510-1628
(845) 421-4013
Mailing address
780 LYNNHAVEN PKWY STE 400, VIRGINIA BEACH, VA 23452-7332
(877) 418-2978
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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