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General NPI Number Information
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NPI Number | 1912721259
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Entity Type | Organization
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Legal Business Name | MOMS OFFERING MEANINGFUL SUPPORT, LLC
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 231 COBBLE STONE DR
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City | WINCHESTER
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State | VA
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Zip | 22602
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Country | US
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Telephone | 571-919-5719
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Fax |
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Provider Business Mailing Address
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Address Line | 2045 S PLEASANT VALLEY RD # 1015
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City | WINCHESTER
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State | VA
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Zip | 22601-7001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. TATIANA GARCIA
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Credential | MA, BCBA, LBA
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Telephone | 571-919-5719
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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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