Provider Demographics
NPI:1649247172
Name:PALLE, SRILEKHA R (PT,CKTP)
Entity type:Individual
Prefix:MRS
First Name:SRILEKHA
Middle Name:R
Last Name:PALLE
Suffix:
Gender:F
Credentials:PT,CKTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7569 GREAT SWAN CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-2275
Mailing Address - Country:US
Mailing Address - Phone:703-839-3976
Mailing Address - Fax:
Practice Address - Street 1:2131 K ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1898
Practice Address - Country:US
Practice Address - Phone:202-715-5059
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT870470225100000X
VA2305204102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist