Provider Demographics
NPI:1407318447
Name:SAFI, MOHIBULLAH (BCABA)
Entity Type:Individual
Prefix:
First Name:MOHIBULLAH
Middle Name:
Last Name:SAFI
Suffix:
Gender:M
Credentials:BCABA
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:703-678-9497
Mailing Address - Fax:571-398-2541
Practice Address - Street 1:12531 CLIPPER DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2518
Practice Address - Country:US
Practice Address - Phone:703-678-9497
Practice Address - Fax:571-398-2541
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst