Individual
LARISA A MALTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
6400 ARLINGTON BLVD STE 670, FALLS CHURCH, VA 22042-2336
(703) 992-6938
(866) 499-8840
Mailing address
918 S PATRICK ST APT 4, ALEXANDRIA, VA 22314-4039
(571) 225-6900
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133002821
VA
106S00000X
Behavior Technician
RBT-20-121531
VA
Other
Enumeration date
01/20/2021
Last updated
12/08/2022
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