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NPI 1548734064

NPI 1548734064 : LIZNA KHIMANI BCBA : ALEXANDRIA, VA

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General NPI Number Information
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    NPI Number           |    1548734064
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    Entity Type          |    Individual 
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    Provider Name        |    LIZNA KHIMANI BCBA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/17/2019
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    Last Update Date     |    06/19/2022
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Provider Practice Location Address
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    Address Line         |    3445 BERKELEY ST APT 242 
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    City                 |    ALEXANDRIA
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    State                |    VA
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    Zip                  |    22302-1287
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    Country              |    US
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    Telephone            |    804-728-8827
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14497 POTOMAC MILLS RD # 1013 
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    City                 |    WOODBRIDGE
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    State                |    VA
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    Zip                  |    22192-6807
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    Country              |    US
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    Telephone            |    703-386-6070
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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        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    1-21-49271
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    License Number State |    VA
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Taxonomy #2
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    Taxonomy Code        |    103K00000X
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    Taxonomy Name        |    Behavior Analyst
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    License Number       |    BCABA-18-6155-140249
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    License Number State |    VA
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Taxonomy #3
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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