Provider Demographics
NPI:1811954597
Name:KHOURI, SABAH A (LICENSED ACUPUNCTURI)
Entity type:Individual
Prefix:
First Name:SABAH
Middle Name:A
Last Name:KHOURI
Suffix:
Gender:F
Credentials:LICENSED ACUPUNCTURI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 CARRINGTON RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-1754
Mailing Address - Country:US
Mailing Address - Phone:703-749-9143
Mailing Address - Fax:703-749-9181
Practice Address - Street 1:1430 CARRINGTON RIDGE LN
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-1754
Practice Address - Country:US
Practice Address - Phone:703-749-9143
Practice Address - Fax:703-749-9181
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000296171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0121000296OtherLICENSED ACUPUNCTURIST