Organization
BLUE RIDGE ABA LLC
Active
Other names
Nicole Overstreet, BCBA
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE D OVERSTREET BCBA, LBA (OWNER)
(540) 583-0416
Entity
Organization
Contact information
Practice address
204 PEAKLAND CT, BEDFORD, VA 24523-1229
(540) 583-0416
Mailing address
204 PEAKLAND CT, BEDFORD, VA 24523-1229
(540) 583-0416
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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