Individual
KIM BUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
7960 DONEGAN DR STE 200, MANASSAS, VA 20109-8236
(571) 208-0592
Mailing address
427 CARLISLE DR, HERNDON, VA 20170-5608
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0134000439
VA
106E00000X
Assistant Behavior Analyst
0134000439
VA
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0134000439
VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
01
—
1-22-61833
BEHAVIOR ANALYTIC CERTIFICATION BOARD
—
Enumeration date
02/10/2020
Last updated
01/12/2023
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