Individual
LEIA MANIBUSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
732 EDEN WAY N STE E563, CHESAPEAKE, VA 23320-2798
(540) 915-2114
(757) 485-1989
Mailing address
1708 MCDANIEL ST, PORTSMOUTH, VA 23704-1731
(757) 639-5850
(757) 485-1989
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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