Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst | 0-16-7534 | VA |
NPI | 1073811469 |
---|---|
Provider Name | Miss Kimberly Ann Brickman |
First Address | Ashburn, VA 20148-6420 |
Second Address | Ashburn, VA 20148-6420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2011 |
Last Update Date | 16/12/2016 |