Healthcare Provider Details

I. General information

NPI: 1740994664
Provider Name (Legal Business Name): PRYOR BEHAVIORAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 GRANDON LOOP RD
VIRGINIA BEACH VA
23456-3522
US

IV. Provider business mailing address

1928 GRANDON LOOP RD
VIRGINIA BEACH VA
23456-3522
US

V. Phone/Fax

Practice location:
  • Phone: 757-355-1007
  • Fax: 757-264-6279
Mailing address:
  • Phone: 757-355-1007
  • Fax: 757-264-6279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA PRYOR
Title or Position: OWNER/PRESIDENT
Credential: BCBA, LBA
Phone: 757-355-1007