Kyran Ide
Behavior Technician in Fairfax, VA. Individual provider (NPI-1).
NPI number1619687464
StatusActive
Last updated in NPPESDec 2, 2022
Details
- NPI
- 1619687464
- Entity type
- Individual (NPI-1)
- Name
- Kyran Ide
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 2, 2022
- Certification date
- Dec 2, 2022
- Last updated
- Dec 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
8280 Willow Oaks Corporate Dr Ste 600Fairfax, VA 22031-4516
Phone 888-922-2843
Mailing address
8280 Willow Oaks Corporate Dr Ste 600Fairfax, VA 22031-4516
Phone 888-922-2843
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