Provider Demographics
NPI:1184413247
Name:AUTISM THERAPY FOUNDATION LLC
Entity type:Organization
Organization Name:AUTISM THERAPY FOUNDATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:MATEEN
Authorized Official - Last Name:YOUSUFZAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-286-9878
Mailing Address - Street 1:5077 HAZEL FERGUSON DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6552
Mailing Address - Country:US
Mailing Address - Phone:703-286-9878
Mailing Address - Fax:
Practice Address - Street 1:5077 HAZEL FERGUSON DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6552
Practice Address - Country:US
Practice Address - Phone:703-286-9878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty