Healthcare Provider Details
I. General information
NPI: 1689279168
Provider Name (Legal Business Name): RHIANNON ELIZABETH BUSSING
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/02/2020
Last Update Date: 12/02/2020
Certification Date: 12/02/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
648 INDEPENDENCE PKWY STE 300
CHESAPEAKE VA
23320-5208
US
IV. Provider business mailing address
21600 OXNARD ST STE 1200
WOODLAND HILLS CA
91367-4949
US
V. Phone/Fax
- Phone: 757-776-0790
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: