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1912514381
JARED DETRICK
CHESAPEAKE, VA
NPI
1912514381
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: VA RBT-20-137448)
Enumeration Date
2020-09-29
Last Update Date
2020-09-29
Business Address
JARED DETRICK
4225 PORTSMOUTH BLVD STE B
CHESAPEAKE, VA 23321-2154
Phone number: 757-292-4774
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Mailing Address
JARED DETRICK
4225 PORTSMOUTH BLVD STE B
CHESAPEAKE, VA 23321-2154
Phone number: 757-292-4774
Copy
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