| NPI | 1417747015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKURA TABORN Clinical D Irector 757-602-1029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106S00000X Behavior Technician |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2025-05-08 |
| Last Update Date | 2025-05-08 |