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General NPI Number Information
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NPI Number | 1609755834
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Entity Type | Individual
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Provider Name | JULIA PENNELL
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Gender | Female
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Dates
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Enumeration Date | 09/01/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 4225 PORTSMOUTH BLVD STE B
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2154
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Country | US
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Telephone | 530-906-3347
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Fax |
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Provider Business Mailing Address
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Address Line | 11 KINGSBRIDGE WAY S APT D
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City | CHESAPEAKE
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State | VA
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Zip | 23322-5666
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Country | US
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Telephone | 951-529-7920
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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 | RBT-25-471124
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License Number State | VA
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