MEDICARE: FATEMEH SOLTANMOHAMMADI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1083208359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATEMEH SOLTANMOHAMMADI

Provider Business Mailing Address
First Line	:	12516 SHOEMAKER WAY
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-3783
Country	:	US
Telephone Number	:	240-855-5202
Fax Number	:

Provider Business Practice Location Address
First Line	:	12516 SHOEMAKER WAY
Second Line	:
City	:	NORTH POTOMAC
State	:	MD
Zip	:	20878-3783
Country	:	US
Telephone Number	:	240-855-5202
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2021
Last Update Date	:	02/26/2021

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Directions to “ FATEMEH SOLTANMOHAMMADI ” Practice Location

Language	Start Address	Practice Location

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