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General NPI Number Information
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NPI Number | 1760956163
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Entity Type | Individual
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Provider Name | SARAH ABDEL-WAHAB PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 11166 FAIRFAX BLVD
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City | FAIRFAX
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State | VA
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Zip | 22030-5017
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Country | US
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Telephone | 703-865-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 8219 WESTWOOD MEWS CT
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City | VIENNA
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State | VA
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Zip | 22182-6016
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Country | US
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Telephone | 562-659-0033
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810005928
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License Number State | VA
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