Individual
KATELYN E PRUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
5414 BACKLICK ROAD, C, SPRINGFIELD, VA 22151
(716) 531-5564
Mailing address
419 S WASHINGTON ST, ALEXANDRIA, VA 22314-3629
(716) 531-5564
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27061
VA
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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