Individual
LESLIE AQUERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
704 BRUCE CT, HERNDON, VA 20170-5442
(254) 640-6438
Mailing address
704 BRUCE CT, HERNDON, VA 20170-5442
(254) 640-6438
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
19-101853
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19-101853
BEHAVIOR ANALYTIC CERTIFICATION BOARD
—
Enumeration date
10/16/2019
Last updated
02/25/2020
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