Provider Demographics
NPI:1366016081
Name:FOSTER, CASSANDRE (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:CASSANDRE
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:CASSANDRE
Other - Middle Name:
Other - Last Name:FLANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:262 CRESCENT LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:VA
Mailing Address - Zip Code:24574-3202
Mailing Address - Country:US
Mailing Address - Phone:434-426-2244
Mailing Address - Fax:
Practice Address - Street 1:262 CRESCENT LN
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:VA
Practice Address - Zip Code:24574-3202
Practice Address - Country:US
Practice Address - Phone:434-426-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133002005103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty