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General NPI Number Information
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NPI Number | 1396638953
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Entity Type | Individual
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Provider Name | EDOM ABEBE OTR
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Gender | Female
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 1768 BUSINESS CENTER DR STE 330
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City | RESTON
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State | VA
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Zip | 20190-4882
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Country | US
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Telephone | 703-679-7837
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Fax |
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Provider Business Mailing Address
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Address Line | 7507 ASHBY LN UNIT I
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City | ALEXANDRIA
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State | VA
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Zip | 22315-5214
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Country | US
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Telephone | 325-374-6484
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119010931
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License Number State | VA
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