Provider Demographics
NPI:1568159168
Name:BRUMSKINE, ALTHEA VERONIQUE
Entity Type:Individual
Prefix:
First Name:ALTHEA
Middle Name:VERONIQUE
Last Name:BRUMSKINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 MACON WAY # A
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-1110
Mailing Address - Country:US
Mailing Address - Phone:571-494-2140
Mailing Address - Fax:
Practice Address - Street 1:8405 RICHMOND HWY
Practice Address - Street 2:E
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309
Practice Address - Country:US
Practice Address - Phone:703-896-0760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician