Individual
LATESHA SHINESE COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
7510 GAMBRILL RD, SPRINGFIELD, VA 22153-1809
(509) 842-6958
Mailing address
1390 CHAIN BRIDGE RD STE 50097, MC LEAN, VA 22101-3904
(509) 842-6958
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/05/2020
Last updated
11/16/2023
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