Provider Demographics
NPI:1689972309
Name:HETTLING, CHRISTINE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:HETTLING
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:3101 MAGIC HOLLOW BLVD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-3010
Mailing Address - Country:US
Mailing Address - Phone:757-639-2218
Mailing Address - Fax:800-609-6778
Practice Address - Street 1:3101 MAGIC HOLLOW BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23453-3010
Practice Address - Country:US
Practice Address - Phone:757-639-2218
Practice Address - Fax:800-609-6778
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst