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NPI Code Detail

MEDICARE: GRACIE ABRAHAM CRIBB MA, RBT, QMHP A-C

MEDICARE: GRACIE ABRAHAM CRIBB MA, RBT, QMHP A-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1326812116
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACIE ABRAHAM CRIBB MA, RBT, QMHP A-C
Provider Business Mailing Address
First Line : 2600 PARK TOWER DR STE 200
Second Line :
City : VIENNA
State : VA
Zip : 22180-7394
Country : US
Telephone Number : 443-430-8764
Fax Number :
Provider Business Practice Location Address
First Line : 2600 PARK TOWER DR STE 200
Second Line :
City : VIENNA
State : VA
Zip : 22180-7394
Country : US
Telephone Number : 443-430-8764
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2023
Last Update Date : 05/27/2026

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