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1417615907
SHANE WISENBURG
VIRGINIA BEACH, VA
NPI
1417615907
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: BACB734630)
Enumeration Date
2021-12-02
Last Update Date
2021-12-02
Business Address
SHANE WISENBURG RBT
380 CLEVELAND PL # B
VIRGINIA BEACH, VA 23462-6529
Phone number: 757-416-5290
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Mailing Address
SHANE WISENBURG RBT
380 CLEVELAND PL # B
VIRGINIA BEACH, VA 23462-6529
Phone number:
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