Provider Demographics
NPI:1871997676
Name:AFZAL, SAMRA JALEES
Entity type:Individual
Prefix:
First Name:SAMRA
Middle Name:JALEES
Last Name:AFZAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 TURNING LEAF WAY
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-5406
Mailing Address - Country:US
Mailing Address - Phone:919-624-4124
Mailing Address - Fax:
Practice Address - Street 1:2901 CONCERTO CT
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539-3617
Practice Address - Country:US
Practice Address - Phone:919-624-4124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst