Provider Demographics
NPI:1689312001
Name:EMEFELE, QUINTA (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:QUINTA
Middle Name:
Last Name:EMEFELE
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 KIRBY ST
Mailing Address - Street 2:
Mailing Address - City:MANASSAS PARK
Mailing Address - State:VA
Mailing Address - Zip Code:20111-3401
Mailing Address - Country:US
Mailing Address - Phone:703-598-7099
Mailing Address - Fax:703-988-6909
Practice Address - Street 1:14160 NEWBROOK DR
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-2297
Practice Address - Country:US
Practice Address - Phone:703-842-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-21-56997103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst