Provider Demographics
NPI:1386191062
Name:JAWDAT, ROLA (MSW)
Entity Type:Individual
Prefix:
First Name:ROLA
Middle Name:
Last Name:JAWDAT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 14TH ST NW
Mailing Address - Street 2:APT 714
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-4098
Mailing Address - Country:US
Mailing Address - Phone:202-460-0981
Mailing Address - Fax:
Practice Address - Street 1:2303 14TH ST NW
Practice Address - Street 2:APT 714
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4098
Practice Address - Country:US
Practice Address - Phone:202-460-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG500814481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical