MEDICARE: OHUD ALJALOUD BCBA

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	103K00000X	Behavior Analyst	1-25-85588	VA

General Provider Information

NPI Number	:	1750097184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OHUD ALJALOUD BCBA

Provider Business Mailing Address
First Line	:	6216 OLD KEENE MILL CT
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22152-2323
Country	:	US
Telephone Number	:	571-297-4308
Fax Number	:

Provider Business Practice Location Address
First Line	:	6216 OLD KEENE MILL CT
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22152-2323
Country	:	US
Telephone Number	:	571-297-4308
Fax Number	:

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

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	12/18/2025

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