Princessshamecca Myethel Brent, RBT

Individual provider Active NPI Behavior Technician · Lorton, VA

NPI 1104540194 · NPPES record last updated May 16, 2024

Key facts

NPI
1104540194
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
8530 Cinder Bed Rd
Lorton, VA 22079-1476
Phone
(844) 244-1818
NPI assigned
Oct 3, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X MD
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

8530 Cinder Bed Rd
Lorton, VA 22079-1476

Mailing address

1500 S Douglas Rd Ste 230
Coral Gables, FL 33134-4108
Phone (844) 244-1818

Other providers in Lorton, VA

All providers in Lorton, VA · Behavior Technician in Virginia

Sources for this page

Verify at the official NPI Registry.