Provider Demographics
NPI:1801499546
Name:GULLION, JUDITH KRISTYN (MA, BCBA)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:KRISTYN
Last Name:GULLION
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 BRAEBURN DR.
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153
Mailing Address - Country:US
Mailing Address - Phone:540-588-9582
Mailing Address - Fax:540-380-8155
Practice Address - Street 1:1630 BRAEBURN DR.
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-2415
Practice Address - Country:US
Practice Address - Phone:540-588-9582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst