Provider Demographics
NPI:1407627581
Name:FITE, KYLE ANDREW (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:ANDREW
Last Name:FITE
Suffix:
Gender:M
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20838 TIMBERLAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7241
Mailing Address - Country:US
Mailing Address - Phone:434-214-8112
Mailing Address - Fax:434-220-0103
Practice Address - Street 1:20838 TIMBERLAKE RD STE B
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-7241
Practice Address - Country:US
Practice Address - Phone:434-214-8112
Practice Address - Fax:434-220-0103
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133003393103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst