Healthcare Provider Details

I. General information

NPI: 1841112570
Provider Name (Legal Business Name): KOSAR ABDI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1936 OPITZ BLVD
WOODBRIDGE VA
22191-3360
US

IV. Provider business mailing address

231 SIKURA CIRCLE
AURORA ONTARIO
L4G 3Y8
CA

V. Phone/Fax

Practice location:
  • Phone: 540-424-6767
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133005334
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: