Individual
MS. FARAH FAZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4530
(571) 423-4900
Mailing address
8270 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4530
(571) 423-4900
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0813000647
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0813000647
—
VA
Enumeration date
06/14/2021
Last updated
06/14/2021
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