Individual
DEJA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
640 INDEPENDENCE PKWY STE 400B, CHESAPEAKE, VA 23320-5205
(757) 267-9634
Mailing address
4108 JENNIFER CRES, CHESAPEAKE, VA 23321-3143
(757) 275-5385
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
VA
Other
Enumeration date
03/31/2021
Last updated
07/24/2021
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