Provider Demographics
NPI:1730382078
Name:VISALLI-GOLD, DANA ANN (PHD, BCBA)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:ANN
Last Name:VISALLI-GOLD
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 OAK FOREST LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2124
Mailing Address - Country:US
Mailing Address - Phone:347-424-5833
Mailing Address - Fax:
Practice Address - Street 1:5272 RIVER RD STE 100
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-1454
Practice Address - Country:US
Practice Address - Phone:301-718-1716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA086103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst