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Individual

PHAEDRA M ELTAWILA ALMAJID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2106 GALLOWS RD # E, VIENNA, VA 22182-3961
(571) 766-8455
(703) 665-1241
Mailing address
1573 NORTHERN NECK DR, SUITE 201, VIENNA, VA 22182-5566
(202) 999-9317
(703) 665-1241

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-000337
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568778587
VA
Enumeration date
08/27/2010
Last updated
09/21/2015
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