Individual
CHRISTINA GAIL LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LBA
Contact information
Practice address
4120 DOVEVILLE LN, FAIRFAX, VA 22032-1446
(571) 247-8689
Mailing address
4120 DOVEVILLE LN, FAIRFAX, VA 22032-1446
(571) 247-8689
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000216
VA
Other
Enumeration date
03/08/2013
Last updated
05/16/2017
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