Healthcare Provider Details

I. General information

NPI: 1659178945
Provider Name (Legal Business Name): JAMIE CHRISTINE MULLINS BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 LEW DEWITT BLVD STE 401
WAYNESBORO VA
22980-1644
US

IV. Provider business mailing address

3040 AVEMORE SQUARE PL
CHARLOTTESVILLE VA
22911-7228
US

V. Phone/Fax

Practice location:
  • Phone: 540-949-7045
  • Fax: 540-949-8897
Mailing address:
  • Phone: 540-949-7045
  • Fax: 540-949-8897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133004072
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: