Individual
MRS. KELLY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
325 TEAL CRES, VIRGINIA BEACH, VA 23456-4518
(757) 426-2431
Mailing address
325 TEAL CRES, VIRGINIA BEACH, VA 23456-4518
(757) 426-2431
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000916
VA
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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