Provider Demographics
NPI:1821665241
Name:KAZEMI, ROXANA VAGHAR (MFT)
Entity Type:Individual
Prefix:MS
First Name:ROXANA
Middle Name:VAGHAR
Last Name:KAZEMI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 NUTLEY ST SW
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6251
Mailing Address - Country:US
Mailing Address - Phone:703-944-2650
Mailing Address - Fax:
Practice Address - Street 1:200 LITTLE FALLS ST STE 306
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4302
Practice Address - Country:US
Practice Address - Phone:703-231-7991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist