Provider Demographics
NPI:1245057769
Name:ALZABAIDI, MAHA (AGENT)
Entity type:Individual
Prefix:MISS
First Name:MAHA
Middle Name:
Last Name:ALZABAIDI
Suffix:
Gender:F
Credentials:AGENT
Other - Prefix:
Other - First Name:MAHA
Other - Middle Name:
Other - Last Name:A ALZABAIDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7305 HARROGATE CT
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1539
Mailing Address - Country:US
Mailing Address - Phone:703-927-0782
Mailing Address - Fax:
Practice Address - Street 1:7305 HARROGATE CT
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1539
Practice Address - Country:US
Practice Address - Phone:703-927-0782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA372500000X
3747P1801X, 374U00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty