| NPI | 1134670680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES ALLAN KUHAGEN Director 571-594-7673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133000331) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701000511) |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: VA 0811000982) | |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |