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General NPI Number Information
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NPI Number | 1407318447
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Entity Type | Individual
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Provider Name | MOHIBULLAH SAFI BCABA
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Gender | Male
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 12531 CLIPPER DR
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2518
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Country | US
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Telephone | 703-678-9497
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Fax | 571-398-2541
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Provider Business Mailing Address
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Address Line | 12531 CLIPPER DR
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2518
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Country | US
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Telephone | 703-678-9497
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Fax | 571-398-2541
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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