| Evolution Behavioral Health Services, Llc | |
|
23257 Southdown Manor Ter Unit 101 Ashburn VA 20148-8176 | |
| (571) 345-8357 | |
| Not Available |
| Full Name | Evolution Behavioral Health Services, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 23257 Southdown Manor Ter Unit 101, Ashburn, Virginia |
| Authorized Official Name and Position | Marcelo Lorenzo-luaces Pico (DIRECTOR) |
| Authorized Official Contact | 5713458357 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolution Behavioral Health Services, Llc 23257 Southdown Manor Ter Unit 101 Ashburn VA 20148-8176 Ph: (571) 345-8357 | Evolution Behavioral Health Services, Llc 23257 Southdown Manor Ter Unit 101 Ashburn VA 20148-8176 Ph: (571) 345-8357 |
| NPI Number | 1376287276 |
|---|---|
| Provider Enumeration Date | 04/26/2022 |
| Last Update Date | 04/26/2022 |
| Certification Date | 04/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376287276 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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