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General NPI Number Information
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NPI Number | 1992378293
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Entity Type | Organization
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Legal Business Name | GATEWAY 4 ABA
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 913 SYMPHONY CIR SW
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City | VIENNA
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State | VA
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Zip | 22180-5960
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Country | US
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Telephone | 571-338-2955
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Fax |
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Provider Business Mailing Address
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Address Line | 8300 GREENSBORO DR STE L1-255
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City | TYSONS CORNER
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State | VA
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Zip | 22102-3605
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Country | US
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Telephone | 571-338-2955
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHERIE CABALU
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Credential |
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Telephone | 571-338-2955
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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 |
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License Number State |
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