Provider Demographics
NPI:1346743739
Name:ABHILASH, REJI (PHD)
Entity Type:Individual
Prefix:DR
First Name:REJI
Middle Name:
Last Name:ABHILASH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:REJI
Other - Middle Name:
Other - Last Name:MOHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6209 EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3906
Mailing Address - Country:US
Mailing Address - Phone:240-883-9800
Mailing Address - Fax:
Practice Address - Street 1:6209 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3906
Practice Address - Country:US
Practice Address - Phone:240-883-9800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05968103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist