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General NPI Number Information
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NPI Number | 1487431052
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Entity Type | Organization
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Legal Business Name | TPM BEHAVIORAL SUPPORT SERVICES, LLC
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 2409 TRIMARAN WAY
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3080
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Country | US
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Telephone | 804-519-9393
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Fax |
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Provider Business Mailing Address
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Address Line | 2409 TRIMARAN WAY
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3080
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Country | US
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Telephone | 804-519-9393
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TIFFANYE MCKINNEY
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Credential |
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Telephone | 804-519-9393
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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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