Healthcare Provider Details
I. General information
NPI: 1427826486
Provider Name (Legal Business Name): MAJKOGROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/19/2023
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1775 GREENSBORO STATION PL STE 475
MC LEAN VA
22102-5218
US
IV. Provider business mailing address
2000 15TH ST N STE 1003
ARLINGTON VA
22201-2610
US
V. Phone/Fax
- Phone: 703-520-1072
- Fax:
- Phone: 703-520-1072
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DHURATA
MAJKO
Title or Position: OWNER
Credential:
Phone: 703-520-1072