Provider Demographics
NPI:1184905523
Name:TABIBIAN, HEDIYEH (MSPT)
Entity type:Individual
Prefix:MS
First Name:HEDIYEH
Middle Name:
Last Name:TABIBIAN
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MS
Other - First Name:HEIDI
Other - Middle Name:
Other - Last Name:TABIBIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSPT
Mailing Address - Street 1:11575 SENECA HILL CT
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-1366
Mailing Address - Country:US
Mailing Address - Phone:703-981-6588
Mailing Address - Fax:
Practice Address - Street 1:11575 SENECA HILL CT
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:VA
Practice Address - Zip Code:22066-1366
Practice Address - Country:US
Practice Address - Phone:703-981-6588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205366225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist