Provider Demographics
NPI:1831883594
Name:ARRAZZAAQ, TAJ MOHAMMED
Entity type:Individual
Prefix:
First Name:TAJ
Middle Name:MOHAMMED
Last Name:ARRAZZAAQ
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 1:3105 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6209
Mailing Address - Country:US
Mailing Address - Phone:314-243-6969
Mailing Address - Fax:
Practice Address - Street 1:3105 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6209
Practice Address - Country:US
Practice Address - Phone:314-243-6969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst