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General NPI Number Information
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NPI Number | 1063975589
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Entity Type | Individual
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Provider Name | JOSEPH KYLE ADAMS BCBA, LBA
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Gender | Male
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 155 CREEKSIDE LN
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City | WINCHESTER
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State | VA
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Zip | 22602-2447
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Country | US
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Telephone | 540-208-7822
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Fax | 540-208-7853
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Provider Business Mailing Address
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Address Line | 601 CARROLL DR
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City | STEPHENS CITY
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State | VA
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Zip | 22655-2750
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Country | US
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Telephone | 540-905-6735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0133001364
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License Number State | VA
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