Provider Demographics
NPI:1154662435
Name:HASCALL, MICHELLE M (BCBA)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:HASCALL
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 1:4421 FAIGLE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-4814
Mailing Address - Country:US
Mailing Address - Phone:804-617-5302
Mailing Address - Fax:
Practice Address - Street 1:4421 FAIGLE RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-4814
Practice Address - Country:US
Practice Address - Phone:804-617-5302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst