| Classic Aba Services | |
|
1964 Gallows Rd Ste 302 Vienna VA 22182-3814 | |
| (703) 717-2745 | |
| Not Available |
| Full Name | Classic Aba Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1964 Gallows Rd Ste 302, Vienna, Virginia |
| Authorized Official Name and Position | Shohreh Tousi (OWNER/DIRECTOR) |
| Authorized Official Contact | 7037172745 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Classic Aba Services 1964 Gallows Rd Ste 302 Vienna VA 22182-3814 Ph: (703) 717-2745 | Classic Aba Services 1964 Gallows Rd Ste 302 Vienna VA 22182-3814 Ph: (703) 717-2745 |
| NPI Number | 1598506602 |
|---|---|
| Provider Enumeration Date | 06/03/2024 |
| Last Update Date | 06/03/2024 |
| Certification Date | 06/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598506602 | NPI | - | NPPES |
| 1427667096 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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