Provider Demographics
NPI:1710561543
Name:GILLILAND, ELIZEBETH (BCBA)
Entity Type:Individual
Prefix:
First Name:ELIZEBETH
Middle Name:
Last Name:GILLILAND
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:LIZZIE
Other - Middle Name:
Other - Last Name:GILLILAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, BCBA, LBA
Mailing Address - Street 1:14 PIDGEON HILL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6151
Mailing Address - Country:US
Mailing Address - Phone:703-470-0818
Mailing Address - Fax:
Practice Address - Street 1:14 PIDGEON HILL DR STE 220
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6151
Practice Address - Country:US
Practice Address - Phone:703-994-4809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133002143103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst