| Integrated Autism Behavior Services Llc | |
|
1110 Herndon Pkwy Ste 305 Herndon VA 20170-5547 | |
| (703) 943-6560 | |
| (571) 685-2221 |
| Full Name | Integrated Autism Behavior Services Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1110 Herndon Pkwy Ste 305, Herndon, Virginia |
| Authorized Official Name and Position | Fazlul Khaleq Shuja (PRESIDENT) |
| Authorized Official Contact | 2023406334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Integrated Autism Behavior Services Llc 1110 Herndon Pkwy Ste 305 Herndon VA 20170-5547 Ph: (703) 943-6560 | Integrated Autism Behavior Services Llc 1110 Herndon Pkwy Ste 305 Herndon VA 20170-5547 Ph: (703) 943-6560 |
| NPI Number | 1144951351 |
|---|---|
| Provider Enumeration Date | 06/19/2022 |
| Last Update Date | 04/27/2024 |
| Certification Date | 04/27/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144951351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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