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General NPI Number Information
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NPI Number | 1497340434
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Entity Type | Individual
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Provider Name | OLIVIA JEAN THOMPSON MASPED, BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 3925 MIDLANDS RD
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-2575
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Country | US
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Telephone | 757-585-3216
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Fax | 757-561-2541
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Provider Business Mailing Address
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Address Line | 8616 2ND AVE APT 142
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City | SILVER SPRING
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State | MD
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Zip | 20910
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Country | US
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Telephone | 757-585-3216
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Fax | 757-561-2541
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-147001
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-24-75611
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License Number State |
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