Individual
ABDULLAH MOHAMMED ABDULRAZZAQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
11130 FAIRFAX BLVD, FAIRFAX, VA 22030-5035
(571) 918-9977
Mailing address
11130 FAIRFAX BLVD, FAIRFAX, VA 22030-5035
(571) 918-9977
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT25438516
VA
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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