Organization
BRANCHAUD BEHAVIORAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA HARCUM BRANCHAUD BCBA (OWNER)
(757) 630-6155
Entity
Organization
Contact information
Practice address
5776 GREENWOOD RD, SUFFOLK, VA 23437-9252
(757) 630-6155
Mailing address
5776 GREENWOOD RD, SUFFOLK, VA 23437-9252
(757) 630-6155
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000561
VA
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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