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General NPI Number Information
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NPI Number | 1669183042
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Entity Type | Organization
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Legal Business Name | THRIVE CONSULTATION AND THERAPY
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Dates
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Enumeration Date | 12/07/2022
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 40879 MEADOW VISTA PL
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City | LOVETTSVILLE
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State | VA
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Zip | 20180-2267
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Country | US
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Telephone | 339-298-9495
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Fax |
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Provider Business Mailing Address
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Address Line | 40879 MEADOW VISTA PL
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City | LOVETTSVILLE
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State | VA
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Zip | 20180-2267
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Country | US
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Telephone | 339-298-9495
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | BRIAN CHRISTOPHER BOVINO
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Credential | BCBA, LBA
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Telephone | 339-298-9495
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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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