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Organization

BEAM PEDIATRIC THERAPY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AMANDA FAITH BOETTCHER M.ED., BCBA, LBA (EXECUTIVE DIRECTOR/BEHAVIOR ANALYST)
(540) 455-3107
Entity
Organization

Contact information

Practice address
14313 BROOKMERE DR, CENTREVILLE, VA 20120-4106
(540) 455-3107
(844) 663-2433
Mailing address
14313 BROOKMERE DR, CENTREVILLE, VA 20120-4106
(540) 455-3107
(844) 663-2433

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
VA
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
02/14/2017
Last updated
02/14/2017
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