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General NPI Number Information
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NPI Number | 1841817608
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Entity Type | Individual
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Provider Name | JENNIFER LYNN BURTO M.A., BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 06/28/2020
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 601 CATOCTIN CIR NE BLDG 581
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City | LEESBURG
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State | VA
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Zip | 20176-4964
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Country | US
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Telephone | 703-857-2157
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Fax | 703-777-1935
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Provider Business Mailing Address
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Address Line | 6301 HUDSON CIR
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City | MARSHALL
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State | VA
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Zip | 20115-6554
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Country | US
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Telephone | 954-549-4888
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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 |
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License Number State |
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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 | 0133002308
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License Number State | VA
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