MEDICARE: MAUNDA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1346049822
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAUNDA LLC

Provider Business Mailing Address
First Line	:	1228 PROVIDENCE KNOLL DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-2173
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1228 PROVIDENCE KNOLL DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-2173
Country	:	US
Telephone Number	:	804-617-2498
Fax Number	:

Authorized Official
Title or Position	:	CO-FOUNDER
Name	:	NABIL REZQUI
Credential	:
Telephone Number	:	570-202-5800

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	11/11/2025

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Directions to “MAUNDA LLC ” Practice Location

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