Provider Demographics
NPI:1740538347
Name:RAZAK, JENNIFER L (MGC, CGC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:RAZAK
Suffix:
Gender:F
Credentials:MGC, CGC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7968 HIDDEN BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22153-3208
Mailing Address - Country:US
Mailing Address - Phone:610-608-9455
Mailing Address - Fax:
Practice Address - Street 1:9715 MEDICAL CENTER DR STE 315
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6326
Practice Address - Country:US
Practice Address - Phone:301-681-6772
Practice Address - Fax:301-681-2618
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG0000038170300000X
VA013900025170300000X
170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS