Provider Demographics
NPI:1487213013
Name:ACEITUNO, RACHEL ASYA
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ASYA
Last Name:ACEITUNO
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 1:12162 CARDAMOM DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-1441
Mailing Address - Country:US
Mailing Address - Phone:703-232-4463
Mailing Address - Fax:
Practice Address - Street 1:1411 PRINCESS ANNE STREET
Practice Address - Street 2:
Practice Address - City:FREDRICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401
Practice Address - Country:US
Practice Address - Phone:540-922-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician