Provider Demographics
NPI:1790837565
Name:MOMIN, ANULEKHA (PT)
Entity Type:Individual
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First Name:ANULEKHA
Middle Name:
Last Name:MOMIN
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Gender:F
Credentials:PT
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Mailing Address - Street 1:11240 WAPLES MILL RD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6078
Mailing Address - Country:US
Mailing Address - Phone:703-383-6454
Mailing Address - Fax:703-810-5494
Practice Address - Street 1:13350 FRANKLIN FARM RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-4091
Practice Address - Country:US
Practice Address - Phone:703-810-5205
Practice Address - Fax:703-810-5494
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2020-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2305204898225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist