Individual
KANJANAPA SUPYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
806 NEWTOWN RD, VIRGINIA BEACH, VA 23462-1116
(757) 383-5499
Mailing address
806 NEWTOWN RD, VIRGINIA BEACH, VA 23462-1116
(757) 383-5499
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-25-496549
VA
Other
Enumeration date
12/05/2025
Last updated
12/05/2025
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