Provider Demographics
NPI:1962112482
Name:ZAHARIADES, KELLI (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:ZAHARIADES
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 CAMERON STATION BLVD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-8683
Mailing Address - Country:US
Mailing Address - Phone:203-706-6447
Mailing Address - Fax:
Practice Address - Street 1:1025 CONNECTICUT AVE NW STE 417
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5458
Practice Address - Country:US
Practice Address - Phone:202-528-7223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist