| Autism Unchained Llc | |
|
347 Riceville Rd Java VA 24565-4101 | |
| (434) 770-0049 | |
| Not Available |
| Full Name | Autism Unchained Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 347 Riceville Rd, Java, Virginia |
| Authorized Official Name and Position | Kelsey J Miller (OWNER) |
| Authorized Official Contact | 3025405363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Unchained Llc 347 Riceville Rd Java VA 24565-4101 Ph: (434) 770-0049 | Autism Unchained Llc 347 Riceville Rd Java VA 24565-4101 Ph: (434) 770-0049 |
| NPI Number | 1356062384 |
|---|---|
| Provider Enumeration Date | 09/08/2022 |
| Last Update Date | 07/03/2024 |
| Certification Date | 07/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356062384 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |