Individual
ANGELINE VIRGINIA EATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, M. ED.
Contact information
Practice address
1651 OLD MEADOW RD STE 600, MC LEAN, VA 22102-4389
(703) 506-0123
(886) 857-0246
Mailing address
472 CAPAC RD, BERLIN, MI 48002-4202
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
01-17-28494
CO
103K00000X
Behavior Analyst
1-17-28494
—
Other
Enumeration date
01/16/2018
Last updated
03/02/2020
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