Provider Demographics
NPI:1316325483
Name:HUSSMAN, TONI (LBA, BCBA)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:HUSSMAN
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5036 OCEAN WAY
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-2023
Mailing Address - Country:US
Mailing Address - Phone:618-806-0354
Mailing Address - Fax:
Practice Address - Street 1:5036 OCEAN WAY
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-2023
Practice Address - Country:US
Practice Address - Phone:618-806-0354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000705103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst