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General NPI Number Information
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NPI Number | 1801630009
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Entity Type | Individual
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Provider Name | MOHAMMAD AMAN HAIL RBT
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Gender | Male
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Dates
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Enumeration Date | 06/21/2024
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 16963 CASS BROOK LN
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City | WOODBRIDGE
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State | VA
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Zip | 22191-5115
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Country | US
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Telephone | 720-809-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 16963 CASS BROOK LN
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City | WOODBRIDGE
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State | VA
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Zip | 22191-5115
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Country | US
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Telephone | 720-809-5530
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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 | RBT-24-344435
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License Number State | VA
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