Individual
MAKAYLA STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5265 PROVIDENCE RD STE 504, VIRGINIA BEACH, VA 23464-4210
(844) 854-1116
Mailing address
1500 S DOUGLAS RD STE 230, CORAL GABLES, FL 33134-4108
(844) 854-1116
(305) 846-9711
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-87004
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-87004
REGISTERED BEHAVIOR TECHNICIAN
VA
Enumeration date
05/30/2019
Last updated
11/04/2020
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