Individual
LIBBY BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1332 PLANTATION RD NE, ROANOKE, VA 24012-5713
(540) 795-3053
Mailing address
158 WILDERNESS RD, RUSTBURG, VA 24588-2002
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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