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General NPI Number Information
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NPI Number | 1669360103
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Entity Type | Individual
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Provider Name | COOPER A VALASEK RBT
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Gender | Male
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 10565 FAIRFAX BLVD STE 300
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City | FAIRFAX
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State | VA
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Zip | 22030-3104
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Country | US
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Telephone | 703-218-6599
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Fax |
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Provider Business Mailing Address
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Address Line | 22781 SETTLERS TRAIL TER
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City | BRAMBLETON
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State | VA
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Zip | 20148-6405
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Country | US
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Telephone | 808-255-7851
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Fax |
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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 | BACB835107
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License Number State | VA
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