Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician | RBT-18-55333 | VA |
NPI | 1003307612 |
---|---|
Provider Name | Erin Elizabeth Bunyea |
First Address | Dumfries, VA 22026-3330 |
Second Address | Mc Lean, VA 22102-4311 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2018 |
Last Update Date | 21/05/2018 |