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Individual

DR. AMANDA WILD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EDD, BCBA, LBA, LABA

Contact information

Practice address
12531 CLIPPER DR STE 201, WOODBRIDGE, VA 22192-2355
(571) 398-0428
Mailing address
182 BROOKSIDE DR, NORTH KINGSTOWN, RI 02852-2007
(401) 742-3977

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133003768
VA
103K00000X
Behavior Analyst
LBA00023
RI
103K00000X
Behavior Analyst

Other

Enumeration date
08/28/2016
Last updated
12/07/2025
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