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 |
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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 |
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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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