Provider Demographics
NPI:1932376456
Name:BOADI, OPHELIA T
Entity Type:Individual
Prefix:
First Name:OPHELIA
Middle Name:T
Last Name:BOADI
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 1:601 S CARLIN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-1044
Mailing Address - Country:US
Mailing Address - Phone:703-717-7569
Mailing Address - Fax:703-271-8585
Practice Address - Street 1:601 S CARLIN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-1044
Practice Address - Country:US
Practice Address - Phone:703-717-7569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist