Individual
KATIE DIVELBISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., B.C.B.A.
Contact information
Practice address
5400 SHAWNEE RD, SUITE 208, ALEXANDRIA, VA 22312-2300
(703) 750-0633
(703) 750-0655
Mailing address
5400 SHAWNEE RD, SUITE 208, ALEXANDRIA, VA 22312-2300
(703) 750-0633
(703) 750-0655
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-10-7769
VA
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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