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General NPI Number Information
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NPI Number | 1548647431
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Entity Type | Organization
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Legal Business Name | AUTISM BRIGHT FUTURES, INC.
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 04/30/2015
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Provider Practice Location Address
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Address Line | 237 HANBURY RD E STE. 17-197
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City | CHESAPEAKE
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State | VA
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Zip | 23322-6621
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Country | US
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Telephone | 757-296-0442
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Fax | 252-565-0061
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Provider Business Mailing Address
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Address Line | 237 HANBURY RD E STE. 17-197
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City | CHESAPEAKE
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State | VA
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Zip | 23322-6621
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Country | US
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Telephone | 757-296-0442
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Fax | 252-565-0061
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Authorized Official
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Title or Position | DIRECTOR
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Name | LORENA DECKER
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Credential |
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Telephone | 757-296-0442
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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 | 1-15-18427
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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 | 1-15-18427
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License Number State | NC
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