Provider Demographics
NPI:1043964489
Name:MAFI, GOLNAZ
Entity Type:Individual
Prefix:
First Name:GOLNAZ
Middle Name:
Last Name:MAFI
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 1:5750 BOU AVE UNIT 611
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-5637
Mailing Address - Country:US
Mailing Address - Phone:202-407-2813
Mailing Address - Fax:
Practice Address - Street 1:5750 BOU AVE UNIT 611
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-5637
Practice Address - Country:US
Practice Address - Phone:202-407-2813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst