Provider Demographics
NPI:1346077666
Name:VAFAI, MINOO
Entity type:Individual
Prefix:
First Name:MINOO
Middle Name:
Last Name:VAFAI
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 1:415 CHURCH ST NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5573
Mailing Address - Country:US
Mailing Address - Phone:256-536-4700
Mailing Address - Fax:256-436-4117
Practice Address - Street 1:415 CHURCH ST NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5573
Practice Address - Country:US
Practice Address - Phone:256-536-4700
Practice Address - Fax:256-436-4117
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4741C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical