Provider Demographics
NPI:1801630009
Name:HAIL, MOHAMMAD AMAN (RBT)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:AMAN
Last Name:HAIL
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16963 CASS BROOK LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-5115
Mailing Address - Country:US
Mailing Address - Phone:720-809-5530
Mailing Address - Fax:
Practice Address - Street 1:16963 CASS BROOK LN
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-5115
Practice Address - Country:US
Practice Address - Phone:720-809-5530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-24-344435106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician