Individual
BYRON WINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, BCBA
Contact information
Practice address
1701 BYRD AVE, RICHMOND, VA 23230-3011
(804) 612-1947
(804) 612-1955
Mailing address
1701 BYRD AVE, RICHMOND, VA 23230-3011
(804) 612-1947
(804) 612-1955
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000497
VA
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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