Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1114360823 |
---|---|
Provider Name | Charnetta Kristin Yvonne Epps |
First Address | Virginia Beach, VA 23454-6506 |
Second Address | Virginia Beach, VA 23454-6506 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2013 |
Last Update Date | 28/11/2016 |