Provider Demographics
NPI:1457753899
Name:BADDOUR, SARAH PATRICIA (DPT)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:PATRICIA
Last Name:BADDOUR
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 1:1760 RESTON PKWY
Mailing Address - Street 2:STE 403
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3388
Mailing Address - Country:US
Mailing Address - Phone:703-230-1760
Mailing Address - Fax:703-230-1761
Practice Address - Street 1:1760 RESTON PKWY
Practice Address - Street 2:STE 403
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3388
Practice Address - Country:US
Practice Address - Phone:703-230-1760
Practice Address - Fax:703-230-1761
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305208990225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist