Organization
IMPACT BEHAVIOR CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RUDY (FOUNDER)
(703) 399-1786
Entity
Organization
Contact information
Practice address
108 W GREENWAY BLVD, FALLS CHURCH, VA 22046-4005
(703) 399-1786
Mailing address
108 W GREENWAY BLVD, FALLS CHURCH, VA 22046-4005
(703) 399-1786
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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