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General NPI Number Information
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NPI Number | 1356935597
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Entity Type | Organization
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Legal Business Name | MCLEAN NEUROPSYCHIATRIC TREATMENT CENTER LLC
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Dates
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Enumeration Date | 03/01/2021
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 6849 OLD DOMINION DR STE 315
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City | MC LEAN
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State | VA
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Zip | 22101-3733
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Country | US
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Telephone | 571-378-1398
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Fax | 571-580-0620
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Provider Business Mailing Address
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Address Line | 6849 OLD DOMINION DR STE 315
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City | MC LEAN
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State | VA
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Zip | 22101-3733
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Country | US
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Telephone | 571-378-1398
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Fax | 571-580-0620
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Authorized Official
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Title or Position | OWNER
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Name | AAZAZ HAQ
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Credential | MD
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Telephone | 408-663-1429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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