Provider Demographics
NPI:1558680025
Name:DREYFUS, ADAM (BCBA)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:DREYFUS
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 KINGSCROSS RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-4433
Mailing Address - Country:US
Mailing Address - Phone:804-837-6417
Mailing Address - Fax:
Practice Address - Street 1:1213 KINGSCROSS RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-4433
Practice Address - Country:US
Practice Address - Phone:804-837-6417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst