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General NPI Number Information
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NPI Number | 1174413447
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Entity Type | Organization
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Legal Business Name | SPIRIT ABA VA LLC
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Dates
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Enumeration Date | 07/08/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 999 WATERSIDE DR STE 2525
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City | NORFOLK
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State | VA
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Zip | 23510-3316
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Country | US
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Telephone | 732-267-4591
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Fax |
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Provider Business Mailing Address
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Address Line | 999 WATERSIDE DR STE 2525
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City | NORFOLK
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State | VA
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Zip | 23510-3316
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARK KAUFMAN
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Credential |
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Telephone | 303-276-3995
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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 |
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