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General NPI Number Information
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NPI Number | 1053847558
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Entity Type | Organization
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Legal Business Name | BUILDING BLOCKS LLC
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Dates
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Enumeration Date | 05/04/2017
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 1217 ELMHURST DR
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City | HENRICO
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State | VA
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Zip | 23229-5713
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Country | US
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Telephone | 804-400-9014
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 70463
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City | HENRICO
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State | VA
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Zip | 23255-0463
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Country | US
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Telephone | 804-400-9014
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Fax |
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Authorized Official
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Title or Position | OWNER/DIR OPERATIONS
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Name | MS. CHARLENE FROSTICK
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Credential |
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Telephone | 804-400-9014
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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 |
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License Number State | VA
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