Provider Demographics
NPI:1306500442
Name:BLILEY, DOROTHY (LMT)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:BLILEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 CARROLLSBURG PL SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-4107
Mailing Address - Country:US
Mailing Address - Phone:804-528-6123
Mailing Address - Fax:
Practice Address - Street 1:1801 COLUMBIA RD NW STE 101
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2031
Practice Address - Country:US
Practice Address - Phone:202-780-6694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019016361225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist