Provider Demographics
NPI:1114362217
Name:AUTISM BEHAVRIOAL SOLUTIONS
Entity Type:Organization
Organization Name:AUTISM BEHAVRIOAL SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOLLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:770-940-4571
Mailing Address - Street 1:5413 TANEY AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-2001
Mailing Address - Country:US
Mailing Address - Phone:770-940-4571
Mailing Address - Fax:
Practice Address - Street 1:5413 TANEY AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-2001
Practice Address - Country:US
Practice Address - Phone:770-940-4571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000186251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health