Healthcare Provider Details

I. General information

NPI: 1093230542
Provider Name (Legal Business Name): CHRISTINA M. AVENI-HATCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2017
Last Update Date: 05/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 OLD MEADOW RD STE 600
MC LEAN VA
22102-4389
US

IV. Provider business mailing address

14920 MEANDERWOOD LN
BURTONSVILLE MD
20866-2217
US

V. Phone/Fax

Practice location:
  • Phone: 703-564-1662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: