Provider Demographics
NPI:1912872565
Name:NAVARRO-TIMBERLAKE, RACHAEL NICOLE
Entity type:Individual
Prefix:
First Name:RACHAEL
Middle Name:NICOLE
Last Name:NAVARRO-TIMBERLAKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24805 PINEBROOK RD STE 312
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-4128
Mailing Address - Country:US
Mailing Address - Phone:703-496-4371
Mailing Address - Fax:
Practice Address - Street 1:24805 PINEBROOK RD STE 312
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-4128
Practice Address - Country:US
Practice Address - Phone:703-496-4371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician