Tara Southall, BCaBA
Assistant Behavior Analyst in Roanoke, VA. Individual provider (NPI-1).
NPI number1770026825
StatusActive
Last updated in NPPESFeb 4, 2020
Details
- NPI
- 1770026825
- Entity type
- Individual (NPI-1)
- Name
- Tara Southall
- Credential
- BCaBA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 22, 2016
- Certification date
- Feb 4, 2020
- Last updated
- Feb 4, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106E00000X | Assistant Behavior Analyst | 0134000265 | VA | Yes |
Practice location
1314 Riverland Rd SeRoanoke, VA 24014-3610
Phone 540-566-3670
Mailing address
22 Cross Creek CirCloverdale, VA 24077-3038
Phone 540-272-0462
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All 8 Assistant Behavior Analyst providers in Roanoke · All 6,401 providers in Roanoke
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