Individual
ANASTASIA FORMICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
6245 UNIVERSITY PARK DR, RADFORD, VA 24141-8632
(540) 348-4808
(540) 838-2102
Mailing address
6245 UNIVERSITY PARK DR, RADFORD, VA 24141-8632
(585) 217-7261
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133001835
VA
Other
Enumeration date
12/05/2022
Last updated
01/11/2023
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