Provider Demographics
NPI:1326623281
Name:HAMMAN, TREVOR (BCABA)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:HAMMAN
Suffix:
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 CALEDON CT APT 7
Mailing Address - Street 2:
Mailing Address - City:STEPHENS CITY
Mailing Address - State:VA
Mailing Address - Zip Code:22655-3543
Mailing Address - Country:US
Mailing Address - Phone:540-305-9160
Mailing Address - Fax:
Practice Address - Street 1:2235 CEDAR LN STE 102
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-5247
Practice Address - Country:US
Practice Address - Phone:703-556-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000366106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst