Individual
AMY GARDILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. BCBA
Contact information
Practice address
1514 HOLLAND RD STE 2, SUFFOLK, VA 23434-6517
(757) 644-6391
(757) 622-2011
Mailing address
7460 CENTRAL BUSINESS PARK DR, NORFOLK, VA 23513-2818
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-63861
VA
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
RBT-21-177688
VA
Other
Enumeration date
12/02/2021
Last updated
02/10/2024
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