Provider Demographics
NPI:1376163253
Name:VAIA, JULIE KAY (BCBA, LBA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:KAY
Last Name:VAIA
Suffix:
Gender:F
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 1:5671 COUNTY ROAD 441
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-6716
Mailing Address - Country:US
Mailing Address - Phone:573-795-1443
Mailing Address - Fax:
Practice Address - Street 1:5671 COUNTY ROAD 441
Practice Address - Street 2:
Practice Address - City:HANNIBAL
Practice Address - State:MO
Practice Address - Zip Code:63401-6716
Practice Address - Country:US
Practice Address - Phone:573-795-1443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018019553103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst