Provider Demographics
NPI:1336450758
Name:FOXLEY, SUMMER S (BCABA)
Entity Type:Individual
Prefix:
First Name:SUMMER
Middle Name:S
Last Name:FOXLEY
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8433 RADFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22309-2570
Mailing Address - Country:US
Mailing Address - Phone:703-399-4388
Mailing Address - Fax:
Practice Address - Street 1:8433 RADFORD AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-2570
Practice Address - Country:US
Practice Address - Phone:703-399-4388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0-10-3844103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst