Healthcare Provider Details
I. General information
NPI: 1972914166
Provider Name (Legal Business Name): JULIE ANN MCVAY MA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/11/2014
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8008 E ARAPAHOE CT
CENTENNIAL CO
80112-6839
US
IV. Provider business mailing address
5 REVERE DR STE 120
NORTHBROOK IL
60062-8005
US
V. Phone/Fax
- Phone: 844-247-7222
- Fax:
- Phone: 847-807-3717
- Fax: 847-348-3706
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: