Provider Demographics
NPI:1760091151
Name:BILBREY, JOLENE KAY (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JOLENE
Middle Name:KAY
Last Name:BILBREY
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:JOLENE
Other - Middle Name:KAY
Other - Last Name:STRANLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAIDEN NAME
Mailing Address - Street 1:1502 VISTA RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:VA
Mailing Address - Zip Code:24348-4729
Mailing Address - Country:US
Mailing Address - Phone:276-238-7913
Mailing Address - Fax:
Practice Address - Street 1:140 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141-1787
Practice Address - Country:US
Practice Address - Phone:540-585-3075
Practice Address - Fax:540-585-3075
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001748103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst