Healthcare Provider Details

I. General information

NPI: 1891430542
Provider Name (Legal Business Name): HAND IN HAND BEHAVIORAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 05/02/2023
Certification Date: 05/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 TOWN SQUARE CIR APT 404
STAFFORD VA
22554-1811
US

IV. Provider business mailing address

32 TOWN SQUARE CIR APT 404
STAFFORD VA
22554-1811
US

V. Phone/Fax

Practice location:
  • Phone: 540-840-8722
  • Fax:
Mailing address:
  • Phone: 540-840-8722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: HAWAH JALLOH
Title or Position: OWNER
Credential:
Phone: 540-840-8722