| Impact Aba | |
|
605 Smartts Lane Ne Leesburg VA 20176 | |
| (703) 309-5295 | |
| (703) 935-9723 |
| Full Name | Impact Aba |
|---|---|
| Speciality | Behavior Analyst |
| Location | 605 Smartts Lane Ne, Leesburg, Virginia |
| Authorized Official Name and Position | Janet L Rogers (PRESIDENT) |
| Authorized Official Contact | 7033095295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Aba 605 Smartts Lane Ne Leesburg VA 20176 Ph: (703) 309-5295 | Impact Aba 605 Smartts Lane Ne Leesburg VA 20176 Ph: (703) 309-5295 |
| NPI Number | 1336816065 |
|---|---|
| Provider Enumeration Date | 08/30/2021 |
| Last Update Date | 08/30/2021 |
| Certification Date | 08/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336816065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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