Provider Demographics
NPI:1225802630
Name:ABDULLAH, LA'EEQA
Entity Type:Individual
Prefix:
First Name:LA'EEQA
Middle Name:
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LA'EEQA
Other - Middle Name:
Other - Last Name:KHALILALLAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-0749
Mailing Address - Country:US
Mailing Address - Phone:704-869-2088
Mailing Address - Fax:
Practice Address - Street 1:300 MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-4493
Practice Address - Country:US
Practice Address - Phone:984-528-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC903103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst