Provider Demographics
NPI:1932487709
Name:CHO, GRACE (PHD, BCBA-D)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:DR
Other - First Name:MIHYUN
Other - Middle Name:
Other - Last Name:CHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, BCBA-D
Mailing Address - Street 1:5425 N MORGAN ST
Mailing Address - Street 2:#206
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-5528
Mailing Address - Country:US
Mailing Address - Phone:703-678-9497
Mailing Address - Fax:
Practice Address - Street 1:5425 N MORGAN ST
Practice Address - Street 2:#206
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-5528
Practice Address - Country:US
Practice Address - Phone:703-678-9497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-04-1561103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst