Healthcare Provider Details

I. General information

NPI: 1023517521
Provider Name (Legal Business Name): TANIA SEXTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2018
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10249 HENDLEY RD
MANASSAS VA
20110-7913
US

IV. Provider business mailing address

10740 GENERAL KIRKLAND DR
BRISTOW VA
20136-1373
US

V. Phone/Fax

Practice location:
  • Phone: 703-899-8543
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133003254
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: