Provider Demographics
NPI:1225701923
Name:ABDALLAH, RITA (LISW-S, ACSW)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:
Last Name:ABDALLAH
Suffix:
Gender:F
Credentials:LISW-S, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25092 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-4113
Mailing Address - Country:US
Mailing Address - Phone:440-249-7187
Mailing Address - Fax:
Practice Address - Street 1:25092 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4113
Practice Address - Country:US
Practice Address - Phone:440-249-7187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical