MR. Joshua Kent Vickstrom, B.C.A.B.A.

NPI #1700121134 in Mc Lean, Virginia

Provider Information

NPI Number: 1700121134
Entity Type: Individual
Name: MR. Joshua Kent Vickstrom, B.C.A.B.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Analyst
Credential: B.C.A.B.A.
Enumeration Date: Dec 12, 2012
Last Updated: Dec 12, 2012

Practice Location

Address: 1651 OLD MEADOW RD
Address 2: SUITE NUMBER 600
City: Mc Lean
State: Virginia
ZIP Code: 22102-4311
Phone: (800) 828-5659

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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