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General NPI Number Information
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NPI Number | 1639708894
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Entity Type | Organization
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Legal Business Name | INSPRED BY AUTISM LLC
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 04/08/2020
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Provider Practice Location Address
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Address Line | 2019 CUNNINGHAM DR STE 105
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City | HAMPTON
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State | VA
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Zip | 23666-3316
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Country | US
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Telephone | 562-445-0023
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Fax | 757-788-8636
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Provider Business Mailing Address
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Address Line | 1006 INTREPID CT
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-2415
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Country | US
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Telephone | 562-445-0023
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Fax | 757-788-8636
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Authorized Official
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Title or Position | OWNER
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Name | RAYON TYLER
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Credential |
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Telephone | 562-445-0023
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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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