Provider Demographics
NPI:1164234530
Name:NDZANA, SEME J
Entity type:Individual
Prefix:MR
First Name:SEME
Middle Name:J
Last Name:NDZANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SEME
Other - Middle Name:
Other - Last Name:NDZANA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8118 EDGEWOOD CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2718
Mailing Address - Country:US
Mailing Address - Phone:240-440-1438
Mailing Address - Fax:
Practice Address - Street 1:8118 EDGEWOOD CHURCH RD
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-2718
Practice Address - Country:US
Practice Address - Phone:240-440-1438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP16063101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional