Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 0133001252 | VA |
NPI | 1003478116 |
---|---|
Provider Name | Mrs. Kelly Zapletal Cherry |
First Address | Hampton, VA 23666-3316 |
Second Address | Hampton, VA 23666-3316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2019 |
Last Update Date | 28/06/2019 |