Provider Demographics
NPI:1154793925
Name:ABDULLAH, AMELIA G (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:AMELIA
Middle Name:G
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5204 SUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-2103
Mailing Address - Country:US
Mailing Address - Phone:703-861-0543
Mailing Address - Fax:
Practice Address - Street 1:6231 LEESBURG PIKE
Practice Address - Street 2:SUITE 500
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2102
Practice Address - Country:US
Practice Address - Phone:703-536-1817
Practice Address - Fax:703-536-5677
Is Sole Proprietor?:No
Enumeration Date:2015-10-20
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119006739225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
B030OtherTRICARE
DCK135-0030OtherCAREFIRST
DC388815OtherKAISER