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General NPI Number Information
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NPI Number | 1013403476
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Entity Type | Organization
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Legal Business Name | INSIGHT HOME BEHAVIOR SYSTEMS
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Dates
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Enumeration Date | 07/09/2018
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Last Update Date | 07/09/2018
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Provider Practice Location Address
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Address Line | 1462 S GREENMOUNT DR APT T3
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City | ALEXANDRIA
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State | VA
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Zip | 22311-2321
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Country | US
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Telephone | 781-698-9523
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Fax |
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Provider Business Mailing Address
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Address Line | 1462 S GREENMOUNT DR APT T3
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City | ALEXANDRIA
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State | VA
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Zip | 22311-2321
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Country | US
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Telephone | 781-698-9523
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Fax |
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Authorized Official
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Title or Position | BEHAVIOR ANALYST
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Name | DANIEL JOHN MADDEN
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Credential | BCBA
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Telephone | 781-698-9523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | LBA423
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License Number State | MD
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