Organization
IMAGINE THAT THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOANNA BOUBOULIS (FOUNDER)
(917) 882-8413
Entity
Organization
Contact information
Practice address
1451 BELLE HAVEN ROAD, #410, ALEXANDRIA, VA 22307
(917) 882-8413
Mailing address
1451 BELLE HAVEN RD STE 410, ALEXANDRIA, VA 22307-1201
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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