Provider Demographics
NPI:1528353224
Name:RAZZAK, ZAKIYA (LIC-SW)
Entity type:Individual
Prefix:
First Name:ZAKIYA
Middle Name:
Last Name:RAZZAK
Suffix:
Gender:F
Credentials:LIC-SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7736 MAPLE AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-5601
Mailing Address - Country:US
Mailing Address - Phone:301-706-2240
Mailing Address - Fax:
Practice Address - Street 1:7736 MAPLE AVE APT 10
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-5601
Practice Address - Country:US
Practice Address - Phone:301-706-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500788131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical