Provider Demographics
NPI:1629219191
Name:KANNEH, SATTA Y (DPT)
Entity Type:Individual
Prefix:
First Name:SATTA
Middle Name:Y
Last Name:KANNEH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12850 MIDDLEBROOK RD STE 307
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5244
Mailing Address - Country:US
Mailing Address - Phone:019-724-7523
Mailing Address - Fax:304-972-4836
Practice Address - Street 1:12850 MIDDLEBROOK RD STE 307
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5244
Practice Address - Country:US
Practice Address - Phone:019-724-7523
Practice Address - Fax:304-972-4836
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22801225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist