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General NPI Number Information
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NPI Number | 1194677609
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Entity Type | Individual
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Provider Name | JEFFREY LUKE CENEDELLA
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Gender | Male
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 236 MUSTANG TRL STE 105
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7517
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Country | US
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Telephone | 757-731-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 6104 PARTRIDGE DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23464-1910
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Country | US
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Telephone | 757-235-6032
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | VA
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