Individual
KIERSTYN TALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
231 GARRISONVILLE RD STE 205, STAFFORD, VA 22554-1603
(540) 623-4127
(540) 301-2788
Mailing address
231 GARRISONVILLE RD STE 205, STAFFORD, VA 22554-1603
(540) 623-4127
(540) 301-2788
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-124600
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-20-124600
BACB
—
Enumeration date
06/30/2020
Last updated
06/30/2020
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