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General NPI Number Information
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NPI Number | 1841845757
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Entity Type | Organization
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Legal Business Name | ANALYTIC WELLNESS CENTER LLC
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Dates
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Enumeration Date | 08/07/2019
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Last Update Date | 04/13/2025
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Provider Practice Location Address
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Address Line | 1087 SPRUCE ST
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City | MARTINSVILLE
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State | VA
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Zip | 24112-4506
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Country | US
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Telephone | 276-224-6730
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Fax |
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Provider Business Mailing Address
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Address Line | 764 DOGWOOD DR
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City | MARTINSVILLE
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State | VA
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Zip | 24112-0263
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Country | US
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Telephone | 276-224-6730
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | CRATIA CRASHIA STOCKTON
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Credential | BCBA/LBA
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Telephone | 276-224-6730
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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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