Healthcare Provider Details

I. General information

NPI: 1184255747
Provider Name (Legal Business Name): ALICIA SIMMONS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6216 OLD KEENE MILL CT
SPRINGFIELD VA
22152-2323
US

IV. Provider business mailing address

1263 POTOMAC VISTA DR APT 101
WOODBRIDGE VA
22191-4809
US

V. Phone/Fax

Practice location:
  • Phone: 571-297-4308
  • Fax: 703-992-0405
Mailing address:
  • Phone: 703-232-2506
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: