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Behavioral Analyst

Glen Allen, Virginia

Provider NPI: 1619122348

Organization Information:
Organization is not Subpart
Authorized Official:  JUSTIN LEE CREECH  OWNER/MANAGER  804-4026134

Practice Location:
Tel: 804-402-6134  Fax: 804-418-8096

Business Mailing Address:
Tel: 804-402-6134  Fax: 804-418-8096

Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number


Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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