Provider Demographics
NPI:1578366175
Name:JALLOH, ZAINAB (COTA/L)
Entity type:Individual
Prefix:
First Name:ZAINAB
Middle Name:
Last Name:JALLOH
Suffix:
Gender:
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4072 JASPER LOOP
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-1933
Mailing Address - Country:US
Mailing Address - Phone:703-640-4533
Mailing Address - Fax:
Practice Address - Street 1:2133 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-2655
Practice Address - Country:US
Practice Address - Phone:703-494-3817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131002792224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant