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NPI Code Detail

MEDICARE: VINCENT PHILIP CAMACHO

MEDICARE: VINCENT PHILIP CAMACHO
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 TechnicianRBT-19-107331VA
2103K00000XBehavior Analyst1-24-74766VA

General Provider Information

NPI Number : 1427695402
Entity Type Code : Individual
Provider Name (Legal Business Name) : VINCENT PHILIP CAMACHO
Provider Business Mailing Address
First Line : 1600 N BEAUREGARD ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22311-1704
Country : US
Telephone Number : 703-996-3135
Fax Number :
Provider Business Practice Location Address
First Line : 1600 N BEAUREGARD ST
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22311-1704
Country : US
Telephone Number : 703-996-3135
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2019
Last Update Date : 09/17/2024

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Directions to “ VINCENT PHILIP CAMACHO ” Practice Location

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