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General NPI Number Information
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NPI Number | 1235628124
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Entity Type | Individual
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Provider Name | ALYSA DEVERA
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 231 GARRISONVILLE RD STE 205
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City | STAFFORD
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State | VA
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Zip | 22554-1603
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Country | US
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Telephone | 540-699-2381
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Fax |
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Provider Business Mailing Address
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Address Line | 8260 CAPITOL CIR
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City | KING GEORGE
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State | VA
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Zip | 22485-2154
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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 |
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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 | 0133004602
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0134000361
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License Number State | VA
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