Individual
ELAHA WAZIRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12531 CLIPPER DR STE 201, WOODBRIDGE, VA 22192-2355
(571) 398-0428
Mailing address
12531 CLIPPER DR STE 201, WOODBRIDGE, VA 22192-2355
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133003380
VA
103K00000X
Behavior Analyst
RBT-22-245118
—
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT22-245118
BACB
—
Enumeration date
01/06/2023
Last updated
12/22/2023
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