Provider Demographics
NPI:1548734064
Name:KHIMANI, LIZNA (BCBA)
Entity type:Individual
Prefix:
First Name:LIZNA
Middle Name:
Last Name:KHIMANI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14497 POTOMAC MILLS RD # 1013
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6807
Mailing Address - Country:US
Mailing Address - Phone:703-386-6070
Mailing Address - Fax:
Practice Address - Street 1:3445 BERKELEY ST APT 242
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1287
Practice Address - Country:US
Practice Address - Phone:804-728-8827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2022-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-21-49271103K00000X
VABCABA-18-6155-140249103K00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst