Provider Demographics
NPI:1053148775
Name:ESPIRITU, AUSTIN BERRO
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:BERRO
Last Name:ESPIRITU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13907 AIRFOIL RD
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2566
Mailing Address - Country:US
Mailing Address - Phone:816-833-6962
Mailing Address - Fax:
Practice Address - Street 1:13907 AIRFOIL RD
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2566
Practice Address - Country:US
Practice Address - Phone:816-833-6962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician