Provider Demographics
NPI:1689405672
Name:ZIAIE, POYA (RBT,MED)
Entity type:Individual
Prefix:
First Name:POYA
Middle Name:
Last Name:ZIAIE
Suffix:
Gender:M
Credentials:RBT,MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20327 RIVER RIDGE TER APT 101
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-2684
Mailing Address - Country:US
Mailing Address - Phone:571-481-7508
Mailing Address - Fax:
Practice Address - Street 1:585 CATOCTIN CIR NE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-4981
Practice Address - Country:US
Practice Address - Phone:540-751-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician