Providence Community Aba

NPI #1902570443 in Stafford, Virginia

Provider Information

NPI Number: 1902570443
Entity Type: Organization
Organization Name: Providence Community Aba
Primary Specialty: Behavior Analyst
Enumeration Date: Aug 8, 2021
Last Updated: Jan 23, 2024

Practice Location

Address: 22 KASSY LN
City: Stafford
State: Virginia
ZIP Code: 22556-6577
Phone: (253) 722-9152

Authorized Official

Name: DR. BRIDGET L NKEMATABONG
Title: MANAGER
Phone: (253) 722-9152

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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