Provider Demographics
NPI:1619850922
Name:DRISCOLL, GRACE YAFENG ROGERS
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:YAFENG ROGERS
Last Name:DRISCOLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 PATRICE DR SE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-8972
Mailing Address - Country:US
Mailing Address - Phone:571-465-7704
Mailing Address - Fax:
Practice Address - Street 1:4530 WALNEY RD
Practice Address - Street 2:4530 WALNEY RD
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151
Practice Address - Country:US
Practice Address - Phone:619-795-9925
Practice Address - Fax:877-602-5087
Is Sole Proprietor?:No
Enumeration Date:2025-07-26
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician