Provider Demographics
NPI:1982213047
Name:FIRELINE, CAMERYN (MED)
Entity type:Individual
Prefix:MS
First Name:CAMERYN
Middle Name:
Last Name:FIRELINE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7460 CENTRAL BUSINESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-2818
Mailing Address - Country:US
Mailing Address - Phone:571-235-1887
Mailing Address - Fax:571-359-6784
Practice Address - Street 1:10530 LINDEN LAKE PLZ
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-6434
Practice Address - Country:US
Practice Address - Phone:571-235-1887
Practice Address - Fax:713-596-7845
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst