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Jineon Park

Behavior Technician in Woodbridge, VA. Individual provider (NPI-1).

NPI number1689340366
StatusActive
Last updated in NPPESAug 21, 2021

Details

NPI
1689340366
Entity type
Individual (NPI-1)
Name
Jineon Park
Sex
Female
Sole proprietor
No
Enumeration date
Aug 21, 2021
Certification date
Aug 21, 2021
Last updated
Aug 21, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

12741 Darby Brook Ct Ste 102
Woodbridge, VA 22192-2406

Phone 888-467-8241

Mailing address

12741 Darby Brook Ct Ste 102
Woodbridge, VA 22192-2406

Phone 888-467-8241

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