| Imagine That Therapy, Llc | |
|
1451 Belle Haven Road, #410 Alexandria VA 22307 | |
| (917) 882-8413 | |
| Not Available |
| Full Name | Imagine That Therapy, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1451 Belle Haven Road, #410, Alexandria, Virginia |
| Authorized Official Name and Position | Joanna Bouboulis (FOUNDER) |
| Authorized Official Contact | 9178828413 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Imagine That Therapy, Llc 1451 Belle Haven Rd Ste 410 Alexandria VA 22307-1201 Ph: () - | Imagine That Therapy, Llc 1451 Belle Haven Road, #410 Alexandria VA 22307 Ph: (917) 882-8413 |
| NPI Number | 1063192607 |
|---|---|
| Provider Enumeration Date | 07/19/2023 |
| Last Update Date | 07/19/2023 |
| Certification Date | 07/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063192607 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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