Individual
LAURE GROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., BCBA
Contact information
Practice address
6281 FRANCONIA RD STE B, ALEXANDRIA, VA 22310-2587
(571) 249-4883
Mailing address
6281 FRANCONIA RD STE B, ALEXANDRIA, VA 22310-2587
(571) 249-4883
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133001029
VA
103K00000X
Behavior Analyst
1-15-19647
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0133001029
VA BA LICENSE
VA
Enumeration date
10/09/2015
Last updated
03/17/2018
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