Provider Demographics
NPI:1316290364
Name:CHRISTENSEN, TORY (MSW, BCBA)
Entity type:Individual
Prefix:
First Name:TORY
Middle Name:
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:MSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MASSACHUSETTS AVE NW
Mailing Address - Street 2:APT 905
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-7610
Mailing Address - Country:US
Mailing Address - Phone:319-431-9422
Mailing Address - Fax:
Practice Address - Street 1:5415 BACKLICK RD
Practice Address - Street 2:SUITE C
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-3915
Practice Address - Country:US
Practice Address - Phone:202-368-9543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst