Provider Demographics
NPI:1740730472
Name:PRATT, AMANDA (BCBA)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:PRATT
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:WILKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2727 ENTERPRISE PKWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-6341
Mailing Address - Country:US
Mailing Address - Phone:804-372-0151
Mailing Address - Fax:804-912-2163
Practice Address - Street 1:10124 W BROAD ST STE A
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3330
Practice Address - Country:US
Practice Address - Phone:804-372-0151
Practice Address - Fax:804-912-2163
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2024-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000774103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst