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Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA, LBA

Contact information

Practice address
11 HOPE RD STE 215, STAFFORD, VA 22554-7287
(540) 225-1020
Mailing address
3817 CARLYLE CT, FREDERICKSBURG, VA 22408-9200
(540) 214-6883

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133001341
VA

Other

Enumeration date
07/01/2020
Last updated
07/01/2020
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