Provider Demographics
NPI:1477191252
Name:GEORGE, SAVANNAH G (BCBA)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:G
Last Name:GEORGE
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 1:43616 HABITAT CIR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8254
Mailing Address - Country:US
Mailing Address - Phone:940-300-8698
Mailing Address - Fax:
Practice Address - Street 1:13873 PARK CENTER RD
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-3223
Practice Address - Country:US
Practice Address - Phone:703-225-9365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-12
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
VA0133003313103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician