Provider Demographics
NPI:1427237692
Name:BRAZELA, SALINA (DPT)
Entity type:Individual
Prefix:DR
First Name:SALINA
Middle Name:
Last Name:BRAZELA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 53RD ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-6595
Mailing Address - Country:US
Mailing Address - Phone:215-370-8379
Mailing Address - Fax:
Practice Address - Street 1:14201 SCHOOL LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-2866
Practice Address - Country:US
Practice Address - Phone:202-430-5918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT018937225100000X
MD23080225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist