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General NPI Number Information
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NPI Number | 1932965126
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Entity Type | Organization
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Legal Business Name | INDIGO
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Dates
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Enumeration Date | 02/26/2024
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1432 N GREAT NECK RD STE 103
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-1342
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Country | US
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Telephone | 757-481-0163
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Fax | 757-222-1727
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Provider Business Mailing Address
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Address Line | 1432 N GREAT NECK RD STE 103
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-1342
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Country | US
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Telephone |
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Fax | 757-222-1727
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MILLICENT ALSPAUGH
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Credential |
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Telephone | 757-334-7443
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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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