Provider Demographics
NPI:1831629773
Name:GHEBREMEDHIN, FEVEN (MAT, BCBA)
Entity type:Individual
Prefix:
First Name:FEVEN
Middle Name:
Last Name:GHEBREMEDHIN
Suffix:
Gender:F
Credentials:MAT, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9167 SHEFFIELD HUNT CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1889
Mailing Address - Country:US
Mailing Address - Phone:703-909-9158
Mailing Address - Fax:
Practice Address - Street 1:9167 SHEFFIELD HUNT CT
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1889
Practice Address - Country:US
Practice Address - Phone:703-909-9158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst