Provider Demographics
NPI:1407255979
Name:SUMP, LAYLA ABBY (PHD, BCBA-D, LBA)
Entity Type:Individual
Prefix:
First Name:LAYLA
Middle Name:ABBY
Last Name:SUMP
Suffix:
Gender:F
Credentials:PHD, BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6135 SUMMER PARK LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5223
Mailing Address - Country:US
Mailing Address - Phone:256-452-3011
Mailing Address - Fax:
Practice Address - Street 1:6135 SUMMER PARK LN
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5223
Practice Address - Country:US
Practice Address - Phone:256-452-3011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-12551103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst