MEDICARE: SAHAR DAVARZANI

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	103K00000X	Behavior Analyst	RBT-24-362283	VA

General Provider Information

NPI Number	:	1881414043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAHAR DAVARZANI

Provider Business Mailing Address
First Line	:	45558 LAKE HAVEN TER
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20165-6541
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	45558 LAKE HAVEN TER
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20165-6541
Country	:	US
Telephone Number	:	571-574-0613
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	10/14/2024

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Directions to “ SAHAR DAVARZANI ” Practice Location

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