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Individual

MAKALA ROSE FISHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA, LBA

Contact information

Practice address
12201 GAYTON RD STE 103, HENRICO, VA 23238-8203
(804) 610-2332
Mailing address
12201 GAYTON RD STE 103, HENRICO, VA 23238-8203
(804) 610-2332

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43540
VA
103K00000X
Behavior Analyst
Primary
1-20-43540
WA
106S00000X
Behavior Technician
00003894
WA
106S00000X
Behavior Technician
RBT-17-39493
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0133004551
COMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS
VA
01
1-20-43540
BEHAVIOR ANALYST CERTIFICATION BOARD
VA
01
1-20-43540
BEHAVIOR ANALYST CERTIFICATION BOARD
WA
01
BA61093000
DEPARTMENT OF HEALTH
WA
Enumeration date
02/19/2018
Last updated
04/07/2026
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