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General NPI Number Information
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NPI Number | 1144709908
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Entity Type | Individual
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Provider Name | MS. ISATU SIA SAFFA
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Gender | Female
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Dates
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Enumeration Date | 08/12/2018
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 9870A MAIN ST
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City | FAIRFAX
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State | VA
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Zip | 22031-3908
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Country | US
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Telephone | 571-317-1742
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Fax |
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Provider Business Mailing Address
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Address Line | 12106 WESTLOCK PL
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City | LAUREL
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State | MD
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Zip | 20708-2422
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Country | US
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Telephone | 240-713-0699
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | A00144644
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License Number State | MD
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