Healthcare Provider Details
I. General information
NPI: 1932808235
Provider Name (Legal Business Name): ARK AUTISM BEHAVIOR THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2023
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
661 E MAIN ST
ABINGDON VA
24210-2339
US
IV. Provider business mailing address
13137 THRIFT LN
WOODBRIDGE VA
22193-6102
US
V. Phone/Fax
- Phone: 571-343-9182
- Fax: 571-316-1385
- Phone: 571-343-9182
- Fax: 571-316-1385
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: MR.
WAKIL
QARAR
Title or Position: OWNER/ADMINISTRATOR
Credential: OWNER/ADMINISTRATOR
Phone: 571-343-9182