Provider Demographics
NPI:1467131912
Name:ENHANCED DYNAMICS
Entity Type:Organization
Organization Name:ENHANCED DYNAMICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANISH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA LBA
Authorized Official - Phone:571-464-4299
Mailing Address - Street 1:3900 WESTERRE PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-1339
Mailing Address - Country:US
Mailing Address - Phone:571-464-4299
Mailing Address - Fax:
Practice Address - Street 1:3900 WESTERRE PKWY STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-1339
Practice Address - Country:US
Practice Address - Phone:571-464-4299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty