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General NPI Number Information
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NPI Number | 1023525052
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Entity Type | Individual
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Provider Name | ABIGAIL BUTLER SUITOR
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Gender | Female
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Dates
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Enumeration Date | 12/28/2017
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 4000 RUMFORD LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-2423
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Country | US
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Telephone | 508-561-8980
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 RUMFORD LN
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-2423
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-16-25071
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License Number State | VA
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