Healthcare Provider Details

I. General information

NPI: 1356858674
Provider Name (Legal Business Name): LAURA MARIE PRICE BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7960 DONEGAN DR STE 200
MANASSAS VA
20109-8236
US

IV. Provider business mailing address

131 ELDEN ST STE 302
HERNDON VA
20170-4851
US

V. Phone/Fax

Practice location:
  • Phone: 571-208-0592
  • Fax:
Mailing address:
  • Phone: 571-385-2018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133002758
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: