Diamond Slade
Behavior Technician in Virginia Beach, VA. Individual provider (NPI-1).
NPI number1558099713
StatusActive
Last updated in NPPESAug 15, 2022
Details
- NPI
- 1558099713
- Entity type
- Individual (NPI-1)
- Name
- Diamond Slade
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 15, 2022
- Certification date
- Aug 15, 2022
- Last updated
- Aug 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | t61561019 | VA | Yes |
Practice location
293 Independence Blvd Ste 400Virginia Beach, VA 23462-5461
Phone 757-490-3009
Mailing address
293 Independence Blvd Ste 400Virginia Beach, VA 23462-5461
Phone 757-490-3009
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