Provider Demographics
NPI:1578893061
Name:JAGHLIT, HUDA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:HUDA
Middle Name:
Last Name:JAGHLIT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 MARKET ST
Mailing Address - Street 2:UNIT 366
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5693
Mailing Address - Country:US
Mailing Address - Phone:703-901-1868
Mailing Address - Fax:
Practice Address - Street 1:12000 MARKET ST
Practice Address - Street 2:UNIT 366
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5693
Practice Address - Country:US
Practice Address - Phone:703-901-1868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-05
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004020225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist