Individual
RIAZUL ISLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2680 OPITZ BLVD STE 220, WOODBRIDGE, VA 22192-6821
(703) 497-1771
Mailing address
16934 MONMOUTH CT, DUMFRIES, VA 22026-3252
(757) 705-6557
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810008546
VA
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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