Individual
IBRAHEEM KASSIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
14497 POTOMAC MILLS RD # 1013, WOODBRIDGE, VA 22192-6807
(804) 728-8827
Mailing address
14497 POTOMAC MILLS RD # 1013, WOODBRIDGE, VA 22192-6807
(804) 728-8827
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-392420
VA
Other
Enumeration date
11/18/2024
Last updated
11/18/2024
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