Individual
MRS. SAMANTHA FREEZE BRONK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA
Contact information
Practice address
2001 ENTERPRISE DR, FOREST, VA 24551-2653
(434) 385-1089
Mailing address
2001 ENTERPRISE DR, FOREST, VA 24551-2653
(434) 385-1089
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133003348
VA
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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