Provider Demographics
NPI:1043886807
Name:IMRAN, NOOR (CCMA, CMAA,CPT)
Entity Type:Individual
Prefix:
First Name:NOOR
Middle Name:
Last Name:IMRAN
Suffix:
Gender:F
Credentials:CCMA, CMAA,CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13212 KINNICUTT DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5655
Mailing Address - Country:US
Mailing Address - Phone:703-659-7484
Mailing Address - Fax:
Practice Address - Street 1:13212 KINNICUTT DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5655
Practice Address - Country:US
Practice Address - Phone:703-659-7484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator