Organization
BEHAVIORAL MOMENTUM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE WILCOX BCBA (FOUNDER)
(443) 540-0120
Entity
Organization
Contact information
Practice address
574 EDMONTON TER NE, LEESBURG, VA 20176-1829
(443) 540-0120
Mailing address
574 EDMONTON TER NE, LEESBURG, VA 20176-1829
(443) 540-0120
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
133000306
VA
252Y00000X
Early Intervention Provider Agency
133000306
VA
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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