| Doctor Name: | MIRA WAHBA |
| NPI Number: | 1093194300 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 2305209399 |
| Business Practice Address: | 8316 Arlington Blvd Suite 600 Fairfax, VA - 220315207 |
| Business Phone Number: | 7032051919 |
| Business Fax Number: | 7032051977 |
| Mailing Address: | 5252 Lyngate Ct, Suite 203 BURKE |
| State: | VA |
| Postal Code: | 220151672 |
| Phone Number: | 7032392300 |
| Fax Number: | 7032392301 |
| NPI Enumeration Date: | 05/20/2015 |
| NPI Last Update Date: | 06/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2305209399 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |