Provider Demographics
NPI:1083208359
Name:SOLTANMOHAMMADI, FATEMEH
Entity Type:Individual
Prefix:
First Name:FATEMEH
Middle Name:
Last Name:SOLTANMOHAMMADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12516 SHOEMAKER WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-3783
Mailing Address - Country:US
Mailing Address - Phone:240-855-5202
Mailing Address - Fax:
Practice Address - Street 1:12516 SHOEMAKER WAY
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-3783
Practice Address - Country:US
Practice Address - Phone:240-855-5202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty