Provider Demographics
NPI:1730370040
Name:KAUFMAN, AUTUMN L (BCBA)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:L
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2618 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6405
Mailing Address - Country:US
Mailing Address - Phone:540-450-7899
Mailing Address - Fax:
Practice Address - Street 1:2618 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6405
Practice Address - Country:US
Practice Address - Phone:540-450-7899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1073367101Y00000X
ZZ1-07-3367103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor