Provider Demographics
NPI:1871074898
Name:THANIEL, SHARON DOLORES (MS, BCBA,LBA)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:DOLORES
Last Name:THANIEL
Suffix:
Gender:F
Credentials:MS, BCBA,LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4152 OLD SPRINGFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-1913
Mailing Address - Country:US
Mailing Address - Phone:804-855-9150
Mailing Address - Fax:
Practice Address - Street 1:7617 LITTLE RIVER TPKE STE 110
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2603
Practice Address - Country:US
Practice Address - Phone:703-639-0950
Practice Address - Fax:703-663-8730
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001201103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst