Provider Demographics
NPI:1710408075
Name:BANISH, GABRIELLE ELIZABETH (BCBA)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ELIZABETH
Last Name:BANISH
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:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20146-0232
Mailing Address - Country:US
Mailing Address - Phone:571-464-4299
Mailing Address - Fax:
Practice Address - Street 1:1300 I ST NW STE 400E
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3318
Practice Address - Country:US
Practice Address - Phone:410-609-6357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician