Provider Demographics
NPI:1417620758
Name:PEARSON, DEVON (BA, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:BA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 SUMMIT DR NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24017-4346
Mailing Address - Country:US
Mailing Address - Phone:203-321-5297
Mailing Address - Fax:305-846-9711
Practice Address - Street 1:4512 SUMMIT DR NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24017-4346
Practice Address - Country:US
Practice Address - Phone:203-321-5297
Practice Address - Fax:305-846-9711
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst