Provider Demographics
NPI:1134763857
Name:AKRAM, MOHAMMAD TAAHAAA
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:TAAHAAA
Last Name:AKRAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 FIVE FATHOM CIR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6322
Mailing Address - Country:US
Mailing Address - Phone:571-351-9287
Mailing Address - Fax:
Practice Address - Street 1:2412 FIVE FATHOM CIR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-6322
Practice Address - Country:US
Practice Address - Phone:571-351-9287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty