Healthcare Provider Details

I. General information

NPI: 1134075476
Provider Name (Legal Business Name): SKY LAUREN GREGORY RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 HILLSMAN ST
FALLS CHURCH VA
22043-3336
US

IV. Provider business mailing address

1462 S GREENMOUNT DR APT 405
ALEXANDRIA VA
22311-2325
US

V. Phone/Fax

Practice location:
  • Phone: 703-595-0441
  • Fax: 571-583-9173
Mailing address:
  • Phone: 703-595-0441
  • Fax: 571-583-9173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: