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Individual

AMIR MAHMOUD ISMAIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7400 BEAUFONT SPRINGS DR STE 300, NORTH CHESTERFIELD, VA 23225-5519
(804) 201-9082
Mailing address
4407 PEMBROOK VILLAGE DR, ALEXANDRIA, VA 22309-1864
(929) 309-9560

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-244573
VA

Other

Enumeration date
02/14/2023
Last updated
02/14/2023
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