Provider Demographics
NPI:1952055980
Name:DOAN, TRANG THI MINH (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:TRANG
Middle Name:THI MINH
Last Name:DOAN
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 1:3300 LISTERBROOK CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1927
Mailing Address - Country:US
Mailing Address - Phone:404-435-7780
Mailing Address - Fax:
Practice Address - Street 1:10124 W BROAD ST STE A
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-3330
Practice Address - Country:US
Practice Address - Phone:804-372-0151
Practice Address - Fax:804-912-2163
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133002331103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-21-56326OtherTHE BEHAVIOR ANALYST CERTIFICATION BOARD
VA0133002331OtherVIRGINIA DEPARTMENT OF HEALTH PROFESSIONS