Provider Demographics
NPI:1558107557
Name:AHMADZAI, SANAWULLAH (RBT)
Entity type:Individual
Prefix:MR
First Name:SANAWULLAH
Middle Name:
Last Name:AHMADZAI
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12531 CLIPPER DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2518
Mailing Address - Country:US
Mailing Address - Phone:571-505-7340
Mailing Address - Fax:
Practice Address - Street 1:15252 WENTWOOD LN
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4926
Practice Address - Country:US
Practice Address - Phone:571-229-8960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst