Healthcare Provider Details

I. General information

NPI: 1447523048
Provider Name (Legal Business Name): ALEXANDRIA BEHAVIOR ANALYSIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2012
Last Update Date: 12/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 BIRCH LN
ALEXANDRIA VA
22312-2109
US

IV. Provider business mailing address

4920 BIRCH LN
ALEXANDRIA VA
22312-2109
US

V. Phone/Fax

Practice location:
  • Phone: 202-630-1484
  • Fax:
Mailing address:
  • Phone: 202-630-1484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. HEATHER SCHARRE
Title or Position: OWNER
Credential: M.A., BCBA
Phone: 202-630-1484