Provider Demographics
NPI:1194205419
Name:AHMADZADEH, ZOHREH
Entity Type:Individual
Prefix:MRS
First Name:ZOHREH
Middle Name:
Last Name:AHMADZADEH
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 1:31 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4022
Mailing Address - Country:US
Mailing Address - Phone:410-205-2315
Mailing Address - Fax:
Practice Address - Street 1:12944 TRAVILAH RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-1079
Practice Address - Country:US
Practice Address - Phone:240-477-7187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD476103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst