Provider Demographics
NPI:1811203680
Name:PUTTING TOGETHER PUZZLE PIECES LLC
Entity Type:Organization
Organization Name:PUTTING TOGETHER PUZZLE PIECES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MOYHER
Authorized Official - Suffix:
Authorized Official - Credentials:MED; BCBA
Authorized Official - Phone:703-391-1754
Mailing Address - Street 1:3014 GATEPOST LN
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2246
Mailing Address - Country:US
Mailing Address - Phone:703-391-1754
Mailing Address - Fax:
Practice Address - Street 1:3014 GATEPOST LN
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:VA
Practice Address - Zip Code:20171-2246
Practice Address - Country:US
Practice Address - Phone:703-391-1754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-10-6920251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1-10-6920OtherBOARD CERTIFIED BEHAVIOR ANALYST