Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wild Child Therapeutic Services

Organization Behavior Analyst · NPI 1235763384

Wild Child Therapeutic Services is a Behavior Analyst in Roanoke, Virginia. Registered with an NPI since 2020.

In the registry since
2020

Practice location Address checks out

1028 Winona Ave SW
Roanoke, VA 24015-5328
Phone: (540) 815-1693
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X

Record details

NPI number1235763384
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jarel Gordon — Director Of Aba Services · (540) 815-1693
NPI enumeratedFebruary 27, 2020
Last updated in NPPESFebruary 27, 2020
Certification dateFebruary 27, 2020
Mailing address1028 Winona Ave Sw, Roanoke, VA 24015-5328

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