Provider Demographics
NPI:1255220406
Name:TALUKDER, WAHIDA ISLAM
Entity type:Individual
Prefix:
First Name:WAHIDA
Middle Name:ISLAM
Last Name:TALUKDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10712 BALLANTRAYE DR STE 310
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-4702
Mailing Address - Country:US
Mailing Address - Phone:540-784-1973
Mailing Address - Fax:
Practice Address - Street 1:12007 GREYWING SQ APT B3
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1873
Practice Address - Country:US
Practice Address - Phone:146-989-1648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health