MEDICARE: ANJAIL HAQQ MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0906012345	VA

General Provider Information

NPI Number	:	1598159196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANJAIL HAQQ MSW

Provider Business Mailing Address
First Line	:	516 S INDEPENDENCE BLVD STE 104
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1153
Country	:	US
Telephone Number	:	757-262-6961
Fax Number	:

Provider Business Practice Location Address
First Line	:	516 S INDEPENDENCE BLVD STE 104
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23452-1153
Country	:	US
Telephone Number	:	757-262-6961
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2015
Last Update Date	:	03/13/2023

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