Healthcare Provider Details
I. General information
NPI: 1710742226
Provider Name (Legal Business Name): ABOVE AND BEYOND ABA CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2024
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1408 SHADY TREE WAY
CHESAPEAKE VA
23323-2942
US
IV. Provider business mailing address
4445 CORPORATION LN STE 264
VIRGINIA BEACH VA
23462-3671
US
V. Phone/Fax
- Phone: 703-884-0676
- Fax:
- Phone:
- 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 | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RITHLY
JOACHIM
Title or Position: BCBA
Credential:
Phone: 703-884-0676