| Hidden Light Aba Va Llc | |
|
8280 Willow Oaks Corporate Dr Ste 600 Fairfax VA 22031-4516 | |
| (252) 431-0352 | |
| Not Available |
| Full Name | Hidden Light Aba Va Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 8280 Willow Oaks Corporate Dr Ste 600, Fairfax, Virginia |
| Authorized Official Name and Position | Boruch Stefansky (MANAGER) |
| Authorized Official Contact | 2524310352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hidden Light Aba Va Llc 8280 Willow Oaks Corporate Dr Ste 600 Fairfax VA 22031-4516 Ph: () - | Hidden Light Aba Va Llc 8280 Willow Oaks Corporate Dr Ste 600 Fairfax VA 22031-4516 Ph: (252) 431-0352 |
| NPI Number | 1861230542 |
|---|---|
| Provider Enumeration Date | 07/17/2024 |
| Last Update Date | 07/17/2024 |
| Certification Date | 07/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861230542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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