Organization
TIDEWATER AUTISM CONSULTATION AND THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH D LEGG MA, BCBA, LBA (BEHAVIOR ANALYSY)
(757) 604-3394
Entity
Organization
Contact information
Practice address
6676 MAGNOLIA DR, GLOUCESTER, VA 23061-4239
(757) 604-3394
Mailing address
6676 MAGNOLIA DR, GLOUCESTER, VA 23061-4239
(757) 604-3394
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/04/2021
Last updated
01/04/2021
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