Individual
ABDELWAHAB ELTAYEB ELSIRAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12587 FAIR LAKES CIR STE 303, FAIRFAX, VA 22033-3822
(703) 309-8733
Mailing address
12587 FAIR LAKES CIR STE 303, FAIRFAX, VA 22033-3822
(703) 309-8733
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/01/2019
Last updated
02/01/2019
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