Organization
TIDEWATER BEHAVIOR PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA RAE FONTAINE MS, BCBA, LBA (OWNER)
(757) 778-8886
Entity
Organization
Contact information
Practice address
31 ARLINE DR, NEWPORT NEWS, VA 23608-2256
(757) 778-8886
Mailing address
31 ARLINE DR, NEWPORT NEWS, VA 23608-2256
(757) 778-8886
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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