Provider Demographics
NPI:1962161190
Name:JERMAN, MAY KHALED
Entity type:Individual
Prefix:
First Name:MAY
Middle Name:KHALED
Last Name:JERMAN
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 1:43380 APPLE ORCHARD SQ
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7580
Mailing Address - Country:US
Mailing Address - Phone:443-699-9097
Mailing Address - Fax:
Practice Address - Street 1:14608 THERA WAY
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-3451
Practice Address - Country:US
Practice Address - Phone:703-286-9878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst