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General NPI Number Information
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NPI Number | 1396347340
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Entity Type | Organization
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Legal Business Name | PEDEREC INC.
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Dates
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Enumeration Date | 11/14/2020
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Last Update Date | 11/14/2020
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Provider Practice Location Address
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Address Line | 14115 LOVERS LN STE 154
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City | CULPEPER
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State | VA
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Zip | 22701-4158
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Country | US
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Telephone | 757-544-9140
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Fax |
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Provider Business Mailing Address
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Address Line | 14115 LOVERS LN STE 154
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City | CULPEPER
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State | VA
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Zip | 22701-4158
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Country | US
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Telephone | 757-544-9140
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBERT D FAI
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Credential | BEHAVIOR ANALYST
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Telephone | 571-237-7725
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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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