Provider Demographics
NPI:1265001093
Name:TESTER, KASIA (BA, RBT)
Entity Type:Individual
Prefix:
First Name:KASIA
Middle Name:
Last Name:TESTER
Suffix:
Gender:F
Credentials:BA, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 TAPPAHANNOCK DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23509-1528
Mailing Address - Country:US
Mailing Address - Phone:757-323-5777
Mailing Address - Fax:
Practice Address - Street 1:412 INVESTORS PL STE 102
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1185
Practice Address - Country:US
Practice Address - Phone:855-444-9838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABACB671440106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician