Individual
DASHA GABRIELLE ELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
293 INDEPENDENCE BLVD STE 400, VIRGINIA BEACH, VA 23462-5461
(757) 490-3009
Mailing address
1220 GRAYLYN RD, VIRGINIA BEACH, VA 23464-8679
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
B67245859
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396351193
MAXIM
—
Enumeration date
03/17/2022
Last updated
03/17/2022
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