Provider Demographics
NPI:1033467840
Name:HUYNH, ALISA MARIE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:MARIE
Last Name:HUYNH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 13TH STREET S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204
Mailing Address - Country:US
Mailing Address - Phone:301-502-0243
Mailing Address - Fax:
Practice Address - Street 1:2703 13TH ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4803
Practice Address - Country:US
Practice Address - Phone:301-502-0243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0-12-4935103K00000X
VA11623235103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst