Provider Demographics
NPI:1285354035
Name:MAYFIELD, ALIZA
Entity type:Individual
Prefix:MRS
First Name:ALIZA
Middle Name:
Last Name:MAYFIELD
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 1:4106 POTOMAC HIGHLANDS CIR
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-1775
Mailing Address - Country:US
Mailing Address - Phone:919-930-0161
Mailing Address - Fax:
Practice Address - Street 1:8530 CINDER BED RD STE 1300
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1478
Practice Address - Country:US
Practice Address - Phone:302-334-8450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician