Provider Demographics
NPI:1871758748
Name:NAMAZI, SALYA (PHD)
Entity type:Individual
Prefix:DR
First Name:SALYA
Middle Name:
Last Name:NAMAZI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 GEORGIA AVE
Mailing Address - Street 2:#606
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3638
Mailing Address - Country:US
Mailing Address - Phone:410-227-7001
Mailing Address - Fax:
Practice Address - Street 1:8720 GEORGIA AVE
Practice Address - Street 2:#606
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3638
Practice Address - Country:US
Practice Address - Phone:410-227-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05467103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist