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General NPI Number Information
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NPI Number | 1659641330
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Entity Type | Organization
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Legal Business Name | DOMINION BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 810 N BRAEBURN PL
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City | STAUNTON
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State | VA
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Zip | 24401-9008
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Country | US
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Telephone | 540-280-9081
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Fax | 540-886-7380
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Provider Business Mailing Address
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Address Line | 810 N BRAEBURN PL
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City | STAUNTON
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State | VA
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Zip | 24401-9008
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Country | US
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Telephone | 540-280-9081
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Fax | 540-886-7380
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | KAT S MCNEAL
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Credential |
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Telephone | 540-294-4779
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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 | VA
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