Healthcare Provider Details
I. General information
NPI: 1477327401
Provider Name (Legal Business Name): KIDFIRST ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2023
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
40963 BRUZZO WOODS CT
ALDIE VA
20105-2298
US
IV. Provider business mailing address
40963 BRUZZO WOODS CT
ALDIE VA
20105-2298
US
V. Phone/Fax
- Phone: 157-125-1586
- Fax:
- Phone: 571-251-5868
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
KRYSTLE
L
CURLEY
Title or Position: OWNER, CLINICAL DIRECTOR
Credential: BCBA, LBA
Phone: 571-251-5868