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800 Corporate Dr Ste 301 Stafford VA 22554-4889 | |
| (703) 870-3437 | |
| (703) 870-3421 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 800 Corporate Dr Ste 301, Stafford, Virginia |
| Authorized Official Name and Position | Asad Khan (OFFICIAL) |
| Authorized Official Contact | 7038703435 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
14497 Potomac Mills Rd # 1112 Woodbridge VA 22192-6807 Ph: (540) 295-1826 | 800 Corporate Dr Ste 301 Stafford VA 22554-4889 Ph: (703) 870-3437 |
| NPI Number | 1700615697 |
|---|---|
| Provider Enumeration Date | 07/29/2024 |
| Last Update Date | 11/28/2024 |
| Certification Date | 11/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700615697 | NPI | - | NPPES |
| 1700615697 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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