Provider Demographics
NPI:1649308388
Name:RIAZ, IMRAN (PSYD)
Entity type:Individual
Prefix:
First Name:IMRAN
Middle Name:
Last Name:RIAZ
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 K ST NW
Mailing Address - Street 2:SUITE 330
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1002
Mailing Address - Country:US
Mailing Address - Phone:202-567-1065
Mailing Address - Fax:
Practice Address - Street 1:2033 K ST NW
Practice Address - Street 2:SUITE 330
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1002
Practice Address - Country:US
Practice Address - Phone:202-567-1065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY1000563103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical