Provider Demographics
NPI:1902576762
Name:FAQEERZAI, MOHAMMAD SHAFIQ (RBT)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD SHAFIQ
Middle Name:
Last Name:FAQEERZAI
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8871 MOAT CROSSING PL
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-1729
Mailing Address - Country:US
Mailing Address - Phone:571-662-9487
Mailing Address - Fax:
Practice Address - Street 1:8871 MOAT CROSSING PL
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:VA
Practice Address - Zip Code:20136-1729
Practice Address - Country:US
Practice Address - Phone:571-662-9487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician