Provider Demographics
NPI:1962732289
Name:ABUHAMDA, MONA EZZAT (MONA ABUHAMDA)
Entity type:Individual
Prefix:DR
First Name:MONA
Middle Name:EZZAT
Last Name:ABUHAMDA
Suffix:
Gender:F
Credentials:MONA ABUHAMDA
Other - Prefix:
Other - First Name:MONA
Other - Middle Name:EZZAT
Other - Last Name:ABUHAMDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:6842 ELM ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3844
Mailing Address - Country:US
Mailing Address - Phone:703-356-9136
Mailing Address - Fax:
Practice Address - Street 1:6842 ELM ST STE 103
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101
Practice Address - Country:US
Practice Address - Phone:703-356-9136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-08
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003498103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical