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Individual

JESSICA PETRUCELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA, LBA

Contact information

Practice address
2001 ENTERPRISE DR, FOREST, VA 24551-2653
(434) 386-8982
Mailing address
2001 ENTERPRISE DR, FOREST, VA 24551-2653

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000873
VA

Other

Enumeration date
10/24/2016
Last updated
05/02/2023
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