Provider Demographics
NPI:1669068938
Name:THORPE, EVA (BCBA, LP)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:THORPE
Suffix:
Gender:F
Credentials:BCBA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 MARQUIS PL
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6616
Mailing Address - Country:US
Mailing Address - Phone:571-286-2780
Mailing Address - Fax:
Practice Address - Street 1:6216 OLD KEENE MILL CT
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-2323
Practice Address - Country:US
Practice Address - Phone:571-297-4308
Practice Address - Fax:703-992-0405
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-20-46640103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst