Provider Demographics
NPI:1457153157
Name:DONAS-MOZINGO, ELENI (RBT)
Entity type:Individual
Prefix:
First Name:ELENI
Middle Name:
Last Name:DONAS-MOZINGO
Suffix:
Gender:
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5306 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20187-9380
Mailing Address - Country:US
Mailing Address - Phone:877-780-8262
Mailing Address - Fax:
Practice Address - Street 1:10807 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4730
Practice Address - Country:US
Practice Address - Phone:888-574-6007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1199202106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician