Organization
BEHAVIORAL THERAPY AND CONSULTATION VA LLC
Active
Organization
BEHAVIORAL THERAPY AND CONSULTATION VA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY L EAKIN BCBA (BEHAVIOR ANALYST)
(571) 251-1859
Entity
Organization
Contact information
Practice address
3073 ANTRIM CIR, DUMFRIES, VA 22026-3319
(571) 251-1859
(703) 441-7814
Mailing address
12359 SUNRISE VALLEY DR, 220, RESTON, VA 20191-3462
(571) 251-1859
(703) 441-7814
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
1-09-6402
VA
Other
Enumeration date
03/17/2010
Last updated
03/17/2010
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