Provider Demographics
NPI:1831763424
Name:HOLLINGSWORTH, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:HOLLINGSWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 BRIXHAM CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1921
Mailing Address - Country:US
Mailing Address - Phone:703-774-5819
Mailing Address - Fax:
Practice Address - Street 1:307 MAPLE AVE W STE D
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4307
Practice Address - Country:US
Practice Address - Phone:703-272-8801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-18
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist